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Tf 

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significantly  cnange  the  usual  method  of  filming  are 

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dtt-^--  - 
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'^  obtain  the  best  original 
itures  of  this  copy  which 
M>         ,   -I.    .je,  which  m,ay  alter  any  of 
oe    reproduction,    or   which    may 


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□    Covers  damaged  / 
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□ 

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n 

Q 

j I    Pages  detached/ Panes  detachees 

I  .    I    Showthrough  /  Transparence 

n 


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D 


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Ce  document  est  tiime  au  taux  de  reduction  mdique  ci-dessou*. 


1 


14x 


18x 


12x 


16x 


20x 


22x 


26x 


30x 


24  X 


28x 


32x 


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empreinte. 


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shall  contain  the  symbol  — •■  (meaning     CON- 
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whichever  applies. 


Un  des  symboles  suivants  apparaitra  sur  la 
derniire  image  do  chaque  microfiche,  selon  le 
cas:  le  symbole  — •-  signifie  "A  SUIVRE ",  le 
symbolo  V  signifie    "FIN". 


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method: 


Los  cartes,  planches,  tableaux,  etc..  peuvent  etre 
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Lorsque  la  document  est  trop  grand  pour  etre 
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et  do  haut  en  bas,  en  prenant  le  nombre 
d'irragos  n^cessaire.  Les  diagrammes  suivants 
illustront  la  methode. 


1 

2 

3 

4 

5 

6 

MICROCOPY    RESOLUTION    TEST    CHART 

ANSI  ond  ISO  TEST  CHART  No    2 


1.0 


I.I 


13.6 


2.5 
2.2 

ZO 
1.8 


1.25 


1.4 


.=      ^D^LIED  IIS/MGE     Inc 


■    Mar    Str«l 

■  ■.  • ,  ^p»   ■  •  • 

0;     ••02    -   C 

16)   i88-  5-- 


'-»rL-ncc  Niglain^Mic 


from  a  Hr.itturie  nf  P..:  ■  .  s**"- 


^1 


<^ ;  V 


A  History  of  Nursing 

The      Evolution     of      Nursing      Systems      from 

the     Earliest     Times    to     the     Foundation 

of  the   First    English   and  American 

Training  Schools  for   Nurses 


By 


M.  Adelaide  NuttipL-,   R.   n. 

Superintentlent  of  Nurses,  'Ihc  Juhns  Hopkins  Hospital  : 
Principal  of  Johns  Hopkins  Iraining  School  for  Nurses  ; 
l'n.'siiknt  of  the  Americ:in  Fe<ler  ion  of  Nurses  ;  Member  of 
the   International  Council  of   Nurses; 

and 


f  .,t\  !ni;i   ]      1  ^  ■' 


Member  of  the  Nurses'  Settlement,  New  \'otk  :  Secretary  of  the 
AmL-raan  Federation  of  Nurses  ami  of  the  International 
Council  of  Nurses:  Honorary  Member  of  the  Matrons' Council 
of  Crcat  liritain  ami  Irclancl,  aii'l  of  the  (jerman  Nurses' 
Association, 


In    Two    Volumes 

Volume  Two 


Illustrated 


G.  P.  I'ntnam's  Sons 

New  York  and  London 

Cbc    *nlchcrbochcr     prcee 

1907 


f^^: 


2]t3f  7 


/^il;7-f//'J5,  /^Ir] 


Ci'ivRir.HT,  no? 


O.  1'.  I'U  I'NA.M'b  bONS 


Zbe  linkfecrbocfccr  press,  'Bcw  i'orh 


--I 


CONTENTS 

I'ART    III — FROM    THE    CLOSE    OF    THE     EIGHTEEXTH 

llCNTURY  TO  THE  DEVELOPMENT  OF  MODERN 

NURSING 

PAGE 

CHAPTER   I 

KAISERSWERTH   AND   THE    DEACONESS   MOVEMENT  I 


CHAPTER  H 

PKE-XIGHTIXGALE  TIMES 


63 


CHAPTER  III 

MISS   NIGHTINGALE  AND  THE   CRIMEAN   WAR 


lOI 


CHAPTER  IV 

the  nightingale  school  for  nurses  at  st. 

Thomas's  hospital  ....      172 


CHAPTER  V 
MISS  nightingale's  writings 


207 


CHAPTER  VI 
miss  nightingale's  CO-WORKERS 


287 


HA 


CHAPTER  VII 


THE  TREATV  of  GENEVA  AND  THE   RED  CROSS 
VOL.  II.  iji 


iI2 


IV 


Contents 


CilAl'TICK  \II1 

THE   OF.Vr.I-OrMEXT  OI'   .NTKMNr,   IN    AMKRICA 


326 


(  ii.\i'ti:k  IX 

A   TKIO   or  TKAININi;   SCHOOLS    . 


J/' 


HIBI.IOOKAI'IIY 


IXDEX 


44: 


1 


1 


1 1. 1.  U  ST  RATIONS 


I-LORi:\CK  XiciiTixc.AiJ-:  .  .    I'rontispk 

'I'll;-:  Cradi.i:  ov  Kaiskrswkrth 

1- kif.')i;riki-.  Rhchivks  Pr(jhatiu\e;vS 

I'kii.dkkiki;  Fi.n:i)M;R    . 

Caromxk  Im.ii;i).\i;r 

Si.  John's  IIdusk 

liAKRACK   lr">I>rrAI.   AT   ScCTARI 

Mi>--  Xkiiitimiale's  Xii;i[t  P.uuxds 

S  \IRKV    (IaMP  .... 

Miss  Nichtincai.i.  s  Cri.mi;a.\  Carriac.k 
.\  Ward  in  tiik  I5arr.\ck  II()^.I'HAI, 
A  \V.\ri)  IN  Si.  Thu.mas's  Hospital 

KoO.M   IN   Xh;iITIvc,.\Li.;    IfoMK 

Ward  in  St.  I^artiiolomkw's  in  1833 

<  Ml)  Hkli.evue  Hospital 

i)K.  \'alentink  Shaman 

T.iK  I'lRST  Trained  Xurse  in  A.merica 

Sifter  Helen        .... 

"The  Xi-RSF "        .  .  .  . 

.V  Li-ssoN  IN  Bandaging 

iV\DGES  OF  THE  HOSPITALS 


10 
lO 
24 

«;4 
120 

160 
1S4 
206 

304 
32S 
340 
352 
394 
402 
40S 
434 


J 


1 


A  HISTORY  OF  NURSING 


CIIAPTl'R   I 


KAisi-;Ks\vi;Krii    ani)    ■iiii-: 

Mi:  XT 


i)i;aconess   movi:- 


TllI-^  river  Rliiu'lifS  bro^d  and  pcaorful  Iirtwx'cii 
its  ]"W.  '^rrvn  l)anks  before  the  little  Noftli 
(jermaii  lnwii  of  Kaiscrs^vrrlh,  and  the  majestic 
old  ••uiiis  (if  tlu'  Kaisn-pfalz  guard  the  entrance 
frnrn  the  boatdancHng  to  the  quiet  streets.  Their 
tcstimmiy  to  a  proud  and  knightly  past  is  now  ig- 
nored, and  no  one  thinks  of  Kaiserswerth  excejit 
a.  the  honu'  of  the  f.iinous  Deaconess  Mothrr- 
hojse — as  a  sort  of  shrine,  to  wliieh  i-il.i^riinages 
may  be  made  in  lo\ing  and  grateful  memories 
of  tlie  simple,  self-forgetting  devotion  of  its 
founders.  In  this  (juiet,  remote  village  beat  hearts 
whose  rhythm  started  waves  th:it  ha\e  spre.id 
over  the  earth.  The  direct  and  indirect  exten- 
sions of  humane  endeavour  dating  from  Kaisers- 
werth may  indeed  be  likened,  according  to  the 
favourite  simile  of  the  German  pastors,  to  the  vast 
tree  beginning  as  a  tiny  acorn,  whose  branches 
cover  all  the  earth.  In  and  aroiind  the  little 
town  itself  now  stand  eleven  noble  institutions. 


A  History  of  Nursing 


which  have  pjrowTi  from  the  Motherhousc.  Kx- 
tensi\-e  ;inf'  s]i;icit)us  nioiiern  liuil(Hn,i:;s  fitliMl 
with  every  device  of  science  for  tlie  care  of  tlie 
sick  aivl  the  depenileiit  stand  in  llie  lieautiful 
lart^c  1,'ardeiis  i  if  htwn,  trees,  and  shrill  ilii.'ry,  so 
cliaractei-istie  of  German  institutions,  and  away 
heyond  all  of  these  is  ;i  tine  farm.  On  tlu-  main 
street  <>{  tho  \illa;j;e.  with  its  coMilrs  and  quaint 
old-lime,  two-storv,  white-painte(l,  lowdmilt 
houses  that  havi-  a  han,L;in!j;  .garden  in  I'wry  win- 
dow, stanils  the  Motherhousc  with  its  simple  and 
unpretendini;  but  cxtensi\-e  front,  tlanked  at  one 
end  by  the  older  buildint^  with  its  charminL,^ 
curved  facade.  Back  and  biA'ond  this  buildini^ 
ihrouLjh  tlir  luxuriant  ,uardens,  jiast  the  shadv 
jxirelu'S  of  the  llnusr  of  l".\Tnini;  Ktst,  where  live 
the  aged  Sisters  (who  ha\-e  served  throuL;h  their 
lives  and  have  now  come  Ivick  here  in  tlu'  evenini^ 
of  their  la\s  to  be  taken  care  of),  and  the  home 
for  sui)fr.innuatrd  men  who  haw  s'Twii  the 
cstablisliment  and  art.'  now  ha\'ini!;  their  praceful 
days,  stands  the  Kaiserswerth  Museum,  where 
the  Sisters  have  collected  their  treasuns  from  all 
corners  of  the  earth.  Here  are  a  huj^e,  stuff ei  1  croco- 
dile from  the  Xile;  stone  slabs  with  Egyi)tian 
hicroj^lyphics  and  .\ss\rian  records;  cuneiform 
tablets,  models  of  tlu'  b.astcrn  it  mjiKs  auii  <  t  the 
branch  houses  in  distant  lantls;  itlols  of  e\ery 
nation;  costumes  of  every  Oru  nlal  style;  thorns 
from  the  Mount  of  Calvary;  curious  natural  pro- 
ducts; the  handiwork  of  barl)aric  races  and  curios 


1 


Raiscrswcrth  and  the  Deaconess 

iiinunuTublf.     On  :i  lontj  taMe  in  the  middle  of 
\hc  Museum  is  a  colleclion  of  articles  ].ii'kcd  up 
!,v  the  nursing  deaconesses  on  many  a   lield  of 
lattle;  helmets,  vveaiions,   and  accoutrements  of 
War:  kna])saeks,  fla-s,  and  cooking  utensils.    Then 
there  is  a  casi'  full  of  medals  whit^h  have  been 
hestowcd  either  on  indi\-idual  Sisters  for  bravery 
m  limes  of  war  and  ])estilenee,  or  on  ihe  Mother- 
house    as    an    institution.      Again    bevond    and 
behind    the    Museum    are    more    gardens,  tin  ii  a 
roadway,  and  then,  almost  burie.l  in  green,  one 
comes  up-'U   the   tiny,   two-roomed   cottage,   the 
first   refuge   for   discharged   women   prisoners   in 
Ciermany— the  s])ot  where  Frie<lerike  and  Theodor 
Fliedner,  in  j^y  and  hi -pe,  sheltered    the   historic 
Minna,  their  first  refugee.     This  was  the  cradle 
of   the    Kaiserswerth    institutions.     Beyond    this, 
again,  stands  an  old  tower,  onee  a  mi:':,  n^w  a 
water-tower,   and   from   its   broad    bast-   grows   a 
row  of  little  dwellings.     Ihre  was  the  first  Selv  .'  .1 
•.  r    Deaconesses,  and  lure   Miss    Nightingale  and 
A-nes   fones  lixcd  during  their  slay  at  Kaisers- 
werth. "  This  liny  refuge;  this  raw  of  cottages  and 
the  small  shady  garden  where  "  Mother"  ITioh^er 
used  to  sit  or  walK   in  the  evening,   kniiling   in 
hand,  while  she  counselled  the  dilferent  ones  who 
came  to  her  for  advice,  form  the  heart  of  Kaisers- 
werth.'     Ihre    rritderike,  creative,   a  woman   f)f 

<  III  1886  thu  deaconesses  boufiht  the  little  y;.inlen  housi-, 
•hich  had  LelotiKed  to  the  parish,  atul  pres<.M.ted  it  X<>  the 
MuUierhuusc-  on  its  fiftieth  anniversary. 


i 


4 


A  History  of  Nursi 


ng 


lK)uni]less    courage     and     overflowin.ir    devotion, 
br-'Hi-ht  into  existence  the  trainin-  of  deaconesses.' 
I  he  Kaiserswerlh  deaconesses  now  number  nearly 
lour  thousand,  .-md  under  their  care  are  more  than 
fifty  hospitals,  numerous  orphana.ua-s,  more  than 
forty  infant  seliools,   ten  schools  for   the  hic^her 
education  of  ,^irls,  with  special    schools,  such   ;is 
those  for  the  blind,  deaf  and  dumb,  for  manual 
work,  institutions  for  ner\-ous  and  insane^  patients, 
for  the  trainin,i,r  and  brfriendin.i^r  r,f  youn-  w.,nieii 
m    domestic   service,    for    the   rescue   anil    aid    of 
tallen   j^-.rls,   for   the'  recupt'ration    of   the  Sisters, 
convalescrnt  homes,  and  othn-s. 

The  br-aiirh  or  dau-htcr  houses,  some  thirty 
in  all.  are  found  all  over  (iermanv  as  W(>11  as  ii", 
many  forei-n  countries.  l-:sj)eciallv  interesting 
are  those  at  Jenisalun,  Alexandria,  Cairo,  Beirut 
Smyrna,  and  Bucharest.  Xot  onlv  its  own 
'!au-htrr  h(,uses,  but  all  independent 'institutions 
for  deaconesses  owe  their  existence  to  Kaisers- 
werth,  for  all  subse(iuent  work  wrou<,dit  bv 
(ieaeonesses  wliethtT  in  France,  Sw.tzerhmd  (ir 
America,  whethrr  butlieran,  Methodist,  or  I-Ipis- 
copahan,  has  Inen  the  fruit  of  the  Kaisenswerth 
tree. 

Nnr  is  this  all,— the  whole  development  of 
modern  secular  nursinR,  which  now  encircles  thr 
cnt  re  K'lobe.  traces  us  genealoj^ry  throu-h  Florence 
Ni.k'htin.^rale,  its  direct  founder,  to  Kaisersw-Tth 
and  Us  training  school,  for  it  was  there  that  Miss 
AiKhtmgale  Went  to  study  nursing  system  and 


1 


Kaiserswerth  and  the  Deaconess       5 

nicthoa,  when  she  was  prcparinj^,  unconsciously, 
it  may  be,  for  her  revohitionary  reforms  in  lios- 
pital  organisation. 

It  was  in  1822  that  the  youno-  pastor  Theodor 
Fliedner,  staff  in  haiui.  set   out  on  a  journey  to 
[lollan.l  and  England  to  heg  for  financial  rescue 
tor  his  little  parish  of   Kaiserswerth,  ruined   by 
the  failure  of  a  silk  mill  at  the  very  moment  when 
he  was  installed  there  as  its  shepherd.     He  had 
lieen  offered  another  ])arish,  but  refused  it,  saying 
■  lie  wished    to  be   a   true   shepherd    and    not   a 
hireling."     He  made  at  first,  h(Ave\-er,  a  shv  and 
unsuccessful  beggar,  until  a  wise  bi  other  advised 
him  that  three  things  were  necessary:  "patience, 
boldness,   and  a  fluent  tongue."     With  renewed 
courage  he  wetit  on,  and  with  such  success  that 
on  his  return  he  brought  with  him  a  sum  of  money, 
the  interest  of  which  was  enough  to  support  his 
little  church  and  .Sunday-school,  and   his  associa- 
tion for  young  iiieii.      In  England  (Jueen  Victoria, 
tlv.n  a  little  girl,  headed  the  list,  of  his  subscribers. 
But  of   far  greater  importance  than   the  money 
was  the  knowledge  gained  in  his  journ.v  of  what 
the   world    was   doing.     In    Holland,    deservedly 
lamous   for   its   many   and   excelleni   institutions 
"!  charily  and  philaiithropv,  some  of  which  were 
the  only  ones  tha«    Howard   had  found   to  com- 
mend, and  in  England,  tluti  thrilling  with  all  the 
impulses  which  were   later   to   flower  in   private 
and  statutory  acts  of  reform,  he  visited  numbers  of 
schools  and  educational  institutions,  almshouses. 


A  Iiislorv  of  Nursinsf 


orphanages,  hospitals,  and  prisons,  and  became 
infornic'd  of  the  methods  of  prison  societies.  '"  I 
was  especially  impressed,"  he  wrote,  "with  the 
efficacy  of  the  British  Bible  and  Prison  Societies, 
and  returneil  dee|)ly  shanieil  that  we  in  Gernvmy 
had  done  so  little  for  the  jirisoners."^  In  London 
he  met  ^^rs.  Fry  and  saw  her  work  in  Newgate, 
with  whieh  he  was  deej^ly  impressed.  In  Holland, 
too,  to  his  great  joy,  he  had  seen  the  Mennonite 
deaconesses,  chosen  by  the  church  oiVicers,  li\ing 
in  llieir  own  honics.  but  liusy  in  Uu'ir  jxirish  work 
with  the  poor  and  the  siek.      He  wr(.)le  of  tliem: 

This  praiseworthy  Christian  arrangement  ou^dit 
to  be  intHKluced  into  all  nther  evanj^'elical  churches. 
The  apust'ilic  church  created  the  (iflice  of  deaconess, 
knowinjT  well  that  the  ministrations  of  nun  coul  I 
never  form  a  substitute  for  tender  womanly  feeling 
and  fine  womanly  tail  in  solacing  physical  and  sj)ir- 
itual  distress  especially  amonij  other  women.  ^\  hy 
has  the  modern  Church  not  retained  this  apostolic 
feature;  must  misuse  destroy  every  good  thing?  To 
how  many  women  and  maidens  would  this  not  open 
a  new  and  eonj;enial  field?  ^ 

Fliedner  returned  to  Germany,  and,  full  of  zeal, 
founded  the  Rhenish-Westphalian  Prison  Associa- 
tion  in    i8j6,   the  first  of  its  kind   in   (iennanw 

'  Zur  Erinncrint!^  an  den  Bcsttchdcr  Piakouisscn  An.stult  in 
Kaisersurrth.  Obtainable  at  the  Deaconess  Institute  o: 
Kaiscrswerth. 

'Zur  Erinncrung,  p.  6.  Also  Theodor  Flicdurr,  A'lirr.  r 
Abriss  Seines  LaIh- its,  Gcnrg  Fliedner,  Kaiserswerth  Anslalt, 
1892,  p.  59. 


Kaiscrswerth  and  the  Deaconess 


lie  also,  remembering  that  Klonnc  had  written  a 
'laper  on  the  renewal  of  the  order  of  deaconesses 
wTote  cagerlv  to  him  to  hear  his  views.  While 
he  was  thus  ardent  v/ith  plans  and  projects,  fore- 
most among  which  m  his  mind  were  chose  for 
discharged  prisomis,  whom  he  especially  yearned 
!()  aid,  Fricdcrike  Miinster,  who  was  soon  to  be 
his  wife  and  share  and  double  his  energies,  was 
riigaged  in  sir.iilar  efforts  and  tilled  with  i'leas 
like  his  own. 

Frinlerike  Miinster,  destined  to  become  the 
mother  of  the  revived  apostolic  order  of  deacon- 
isses,  and  the  immediate  ancestress  of  modern 
nursing,  was  born  in  the  year  1800,  just  twenty 
years  before  Miss  Xightingale.  Her  I'irthplace 
w.;<  a  beautiful  and  romantic  S[jot,  the  village 
of  Braunfels  in  the  valley  of  the  L'dm,  where 
rlnstering  cottages,  set  in  ihe  most  t  xrjni^■:te 
fiaine  of  valley,  stream,  atid  forest,  and  o\(T- 
topped  by  a  stately  and  man\--towcn.'d  castle, 
composed  a  scene  ])eculiarly  (icrman,  exprcssne 
at  once  of  the  most  domestic  and  the  most  ideal- 
istic traditions. 

The  spot  had  been  of  old  associated  with  a 
famous  nurse.  Six  hundnd  years  earlier  Eliza- 
i  •  ih,  the  beloved  mother  of  the  poor,  had,  in 
pursuance  of  a  vow,  travelled  barefoot  to  bring 
her  little  daughter  to  the  old  cloister  of  Altenbcrg 
Oiow  no  longer  in  existence)   near  by. 

Friederike's  early  life  was  a  round  of  those  house- 
li'M   and   famil)-   duties  which   are   so  perfect  "- 


A  History  of  Xursinsjf 


j)rcp;irati()n    for  nursiIl.i,^       IlrrlalluT   liail    \)vvn 
a  schoolniasUT ;    later  Com] )t roller  on   the  estate 
of  Prinee  Solnis  BrauT^fe';.     As  a  Vduiit,'  i^irl,  she 
had  been  ae(|u:iinte(l  with  ])0\-ertv  and  struggle, 
but   also   witli   a   life   of   aeti\e   hosi)itality   and 
intimate  association  with  many  kinds  of  ])eo{,lc, — 
from  those  of  the  court  circles,  down  to  the  low- 
liest.    The  joy  of  usefulness   irradiated    Frieder- 
ike's  days,   and   when,    in    her   twentv-fiftii    year, 
the  little  brothers  and   sisters   haxinij  grown    to 
self-support    and    her    father   having    married    a 
second  time  she  was  no  lf)nger  needed  in  the  home, 
she  ofYered  her  \oluntary  services  to  Count  Von 
der    Reeke.    v/Iio    had    founded    an    institute    in 
Dusscltha!    in^ar    Dusseldorf    for    the    rescue    of 
children.     What  her  spirit  was  in  her  service  here 
ean  be  re;,  i  in  the  prayer  which  she  inscribed  in 
her    diar>-;    Dn    hist   die    Lichc,    lass    mich    Licbc 
wcrden !      Two  years  of    this  work  brought  her 
a  severe  illness,  and  whilst  recuperating  from  it 
in  the  home  of  a  friend,   she  was  introduced   to 
pastor    Fliedner,  who  was  then  seeking  for  some 
one  to  befriend  the  female  convicts  in  the  prison 
at  Dusseldorf.     Friederike  had  been  recommended 
to  him  for  her  gifts  of  mind  and  heart,  and  she 
would  have  devoted  herself  gladly  to  the  jirison 
work,  had  not  her  parents  been  unwilling.     But 
when  Fliedner  soon  after  asked  her  in  marriage 
they    consented,  and   Friederike  thenceforth  had 
not  only   the  convicts,  but  tlie  whole  ]>arish  as 
well  on  whicli  to  lavish  her  energies.    From  first  to 


I 

a 


Kaiscrswerth  and  the  Deaconess       9 

last  sh?  pvmixithiscd  activdy  with  her  husluind 
ill  the  prison  mission  work.  Her  lirst  individual 
ilTort  was  to  start  a  woman's  socict}-  for  niirsin,L( 
and  visiting  in  the  homes  of  the  ])oor,  t)f  whom 
thi'ri'  were  many,  in  the  httle  parish,  and  she 
was  herself  untiring  in  visiting,  cooking  for  the 
siek.  nursing  and  cheering  them,  as  I-dizai)eth 
iif  Hungary  had  been  before  her.  "In  thy 
mother's  dealings  with  the  poor  I  learned  what 
tht'  vSeri])ture  means  when  it  sa\-s,  'Let  the  jjonr 
tind  thy  heart,'  "  said  Flictlner'  in  later  life  to  his 
daughter.  She  had  a  special  gift  of  drawing  souls  to 
her.  Her  influence  was  oftenest  a  silent  one,  but  at 
the  right  moment,  she  knew  the  right  wortl  to  say. 
Her  next  work  was  to  establish  knitting  lessons 
for  the  girls.  They  met  in  the  tiny  garden  house 
under  the  direction  of  Fraulein  Frickenhaus  and 
this  nucleus  later  developed  into  the  school  for 
little  children. 2  Paster  Fliedner  was  contmually 
oblige<l  to  travel  from  home  to  colU'ct  money  and 
stimulate  interest  in  the  work  of  the  Prison  Asso- 
ciation, an<l  during  his  many  absences  Fricderike 
managed  the  parish  and  carried  on  every  under- 
taking. It  was  soon  borne  in  upon  them  both 
that  It  was  useless  to  think  of  heljiing  the  prisom-rs 
unless  there  was  some  ])la';e  to  reeeix'e  them  upon 
discharge,  and  Friederike  urged  her  husband  to 
open  a  refuge  for  them. 

'Jahrbiuh     jur     Cbrislluhf     UnU-rludtitui^.      Kaiscrswcrlh, 
l8()4,  p.    10. 
'  Ibid. 


lO 


A  I  lihtorv  of  Nursing 


My  parish  [wrote  I'licdncr!  the  smallest  in  the  coun- 
tr}'  about,  seemed  least  litte(l  t(  .r  sxu  h  an  attempt.  Hut 
none  of  the  elerj.,^}'  of  the  neij^hbourinjj;  {)arishes  would 
undertake  it.  My  wife  insisted  that  we  sliould  make 
the  bejzinnin.tj  and  I  .gladly  aprccd  to  it.  It  was  still 
more  ditVieult  to  find  tlie  riL'ht  u'oman  to  ])la(e  in 
eharj^c, — some  one  wise,  kind,  and  j)atient  cnouj^h. 
But  my  wife  succeeded,  by  ur;,'ent  letters,  in  indueinj^ 
an  old  and  dear  friend.  Katherine  (iobel  of  Rraunfels, 
to  come  to  us  to  talk  it  owr.  Ikr  relations  were 
opposed  to  it.  She  herself  fell  ill,  and  her  e(/ura,i,'e 
wavered,  when  unexpectedly  on  the  17th  of  Sujitember, 
1H33,  a  youni,^  conviet,  Minna  by  name,  just  dis- 
charged t'ri)in  the  penitentiary,  came  in  and  be.u^ed 
piteously  to  stay.  We  couhl  not  refuse,  but  where 
to  i)Ut  her?  In  the  garden  stood  a  tiny  house,  the  fa- 
vourite resort  (jf  the  children,  and  we  domiciled  Minnie 
there.  The  little  house  was  only  t\vel\-e  feet  srpiare. 
and  no  stairway  led  to  its  tiny  garret,  so  Minna 
ascended  fmni  the  outside  on  a  ladder  to  go  to  bed, 
and  the  next  morning  climbed  down  the  same  waw 

This  was  the  seed  that  ijrew  into  the  ,cjrcat  tree. 
From  this  little  i^anlen  htjuse  all  the  institutions 
of  Kaiserswerth  Were  one  by  one  ile\-elo])e(l. 
iM^aiilein  Gob.el  reniaineo  :  ("  Minna  did  ht'r  more 
'^"tnl  than  iron  and  ijiiininc',"  wrote  Fliedtier)  bttt 
Frau  FHedner  In  ire  tlie  brunt  ol  the  care  and  vv- 
sponsibihty  of  the  Refuge  for  the  first  few  years 
of  its  growth,  until  it  became  a  large  and  firmly 
established   asylum. 

The  care  of  the  sick  and  how  to  make  pro- 
vision for  it  was  the  next  engrossing  thought  of 


*    ^' 


X. '; 


7    i:     3 


r. 


^  :  - 


o   _= 


^ 
•^ 

^ 


^ 


i 


Kaiscrswcrth  and  the  Deaconess      n 


Prirderikc's   niolhcr   licarl.'      I'^liL-dncT   shared    it 
Id  the  full. 

The  ihouj^ht  of  llie  sick  pni.r  had  lon^,'  kiin  heavy 
on  our  hearts  [he  wn  ite].  1  l"\v  often  liad  I  .^een  ihein, 
forsaken;  Uieir  Ixiihly  needs  ne.uleeted,  and  their 
s. .uls  quite  f(ir^'(jtten,  fathnt,'  in  their  dull  unhealthy 
eabins  like  leaves  in  autumn;  and  how  many  cities, 
even  large  ones,  were  vviih"Ut  h'^-italr^;  and  even 
wh.cre  tliere  were  hospitals, — I  had  seen  many  on  my 
tra\els  thro\iLdi  Hel,i,dum,  Holland,  En<;land,  ami 
Scotland  and  in  our  own  Germany — often  with. 
marUe-trimmed  exteriors,  but  the  nursing  was 
wretched.  Physicians  eoinplained  bitterly  (jf  the 
hireling:;  service  by  day  and  ni.^ht,  of  the  drunkenness 
and  immorality  of  tlic  attendants.  And  what  is  to 
be  said  of  the  s)>iritual  care?  Little  thouj,'ht  is  i,dven 
to  it.  In  manv  hospitals  j)astors  are  unknown  and 
<  hapcls  not  thou^dit  of.  Would  not  our  young  Chris- 
tian   women    be    able    and    willing    to    do    Christian 


nursmg: 


ad 


it    manv    su(  h    women    performed 


wonders  of  self-sacrilicing  l^ve  in  die  lazarettos  ami 
military  hospitals  of  the  War  of  Freedom?  The 
apostolic  Church  had  utilised  this  force  for  the  benci  t 
'if  tlie  downtrocldcn,  and  through  hundreds  of  years 
had  appointed  wumcn  to  the  diaconatc.  Ought 
we  to  delay  in  bringing  back  consecrated  women 
into  the  service  of  the  Lord?  Such  thoughts  gave 
me  no  rest.  Mv  wife,  also,  was  of  like  mind,  and  of 
far  .greater  coura.ge  than  myself.  But  was  this  little 
Kaiscrswerth,  with  its  preponderating  Catholic  popu- 
lation; where  there  were  not  enough  sick  people  to 

I  Das    Diakoiiisscn    Miillrrlians.   und    sfinc    Tochicrluiuscr. 
Julius  DissclhotT,  KaisLTbwerth,  1893,  p.  7. 


12 


A  History  of  Nursing 


jiroXKle  a 


^.,u. 


fi-r  instriu'ti'in  ■  •uicre  the  general 
poverty  could  promise  no  financial  aiii— could  this 
be  the  right  place  f<ir  a  school  for  evangelical  nurses? 
Were  there  not  mure  experienced  past<irs  than  I, 
better  fitted  for  so  difiieult  an  undertaking'  I  went 
to  my  colleagues  in  Diisseldorf,  Elc'T-fcM,  Barmen, 
etc.,  and  urged  them  to  consider  whether  one  of 
them  might  not  undertake  what  must  be  almost 
necessary  in  their  large  parishes.  Every  one  declined 
my  proposition.  "I  was  the  right  one  to  try  it;  my 
little  parish  gave  me  enough  time  for  it  tlie  tjuict 
seclusion  of  Kaiscrswerth  would  be  fav( curable  to 
such  an  undertaking.  Beside,  the  Lord  did  not 
intend  aii  my  travel  experiences  for  nt)thing.  He 
was  able  to  send  money  to  Kaiserswcrih  and  jjatients 
and  nurses  as  well.'"  ' 

Thus  the  ar^Uirici.ts — no  one  pointed  out  the 
fact,  that  no  other  but  FHedner  knt'W  of  a  wcjnian 
who  could  begin  sueh  a  work  and  build  it  up  to 
completion,  but  this  was  the  trutli.  This  was 
pre-eminently  a  work  that  needr  i  the  .lircction  .if 
a  gifted  woman,  and  pastor  Fliedner  came  liomc 
to  his  wife. 

We  saw  at  last  [he  says]  that  it  was  the  Lord's 
purpose  to  lay  this  task  upon  our  shoulders.  We 
assumed  it  gladly.  We  looked  about  quietly  iur  a 
house  to  use  as  a  hospital.  One  day  the  largest  and 
best  house  in  Kaiscrswerth  was  offered  for  sale.  My 
wife  had  been  confined  only  three  days  before; 
nevertheless,  she  persuaded  me  to  buy  the  house  in 
the  name  of  (he  Lord.  The  price  was  2300  thalers 
'Kufztr  Abriss,  etc.,  pp.  5Q-61. 


Kaiscrswcrth  and  the  Deaconess 


and  wc  had  no  money.  I  bought  it  in  faitli  on  the 
2oth  of  Aprih  1836.     The  money  was  to  be  paid  at 

Christmas. 

Whtii  tlu'  tiiiK'  came  to  pay  the  money,  it  was  all 
in  his  hands;  an  experience  thai  was  often  repeated 
in  later  years.  ^ 

The  hospital  was  not  fitted  tij)  witliout  opposi- 
tion. The  neij^hhours  objected  to  it,  and  there 
w.is  clerical  enmity.  Flii'diier  was  threatened 
that  the  \illa,!.je  authorities  would  eomi)lain  ot 
him  to  the  i^overnnn'iit,  and  the  physicians 
who  h;i(l  been  cnj;aij;ed  to  atteiiii  the  jiatients 
tlioiiKht  it  dani:;erous  lor  I'diedner  to  j.;o  oli  at  that 
moment  on  a  money-collectinj,'  tour,  as  the  general 
excitement  nu.i^ht  lirin.iLi  some  danjjjer  to  his  wife. 
■■  Hut  she  lauK'hed  at  tins,"  writes  I'-liedner,  "and 
sent  me  gaily  mi  my  journey,  lor  she  rehcd  on  a 
hi}j;hcr  p-^-ver."  Finally,  on  the  i6th  of  October 
the  first  patient  came  (a Catholic  maidservant)  and 
on  the  joth  the  first  deaconess  arrived. 

Who  was  happier  than  our  dear  mother?  Fifty 
times  a  day  she  ran  bai  k  and  forth  between  tlie 
parsonage  and  the  hospital,  advising,  providing, 
larrying  furniture,  making  beds  and  arranging  tlic 
rooms,  speaking  a  cheerful  word  to  the  patient  and 
directing  the  helpers,  until  the  inmates  of  the  asylutn 
grew  jealous,  lest  in  the  absorption  of  the  new  work 
the  old  would  be  forgotten.     Rut  this  did  not  hapjH-n.^ 

The  furniture  hat!  all  t)cen  donated  and  was  of 

'  Ziir  firiunrrunf^.  p.  7. 
•  Jalirc,  ill,  p.  14. 


A  I  ii.-^lory  u(  Nursing' 


the  humblest  (k'scription.  A  slial)l>_\-  luMc,  smiu' 
l)rokcn-backe(l  chairs,  worn-out  kni\  cs,  Uvn- 
pr'injfcd  forks,  wi  Tni-calcn  beds,  and  appUantcs 
lo  nialfli  had  i)ccn  sent  in. 

We  movcil  in  with  a  mean  (Aitfit,  but  with  bfnmdless 
joy  and  thunksjijiving.  So  the  small  and  insij^nificant 
seed  of  tlic  dcai'oncss  institute  was  jiJantcd  with 
faith  in  the  way  of  the  Aj)ostolie  Church,  and  it  lias 
had  a  rich  gjowth. 

l'>y  the  end  of  the  month  the.v  wxrv  four  patients 
in  the  house. 

We  may  here  draw  .itte:  lon  to  a  somcwliat 
prevalent  i)Oi>ular  error,  rej^'ardinj,'  the  first  dea- 
conesses, namely,  that  pastor  Fliedner  utilised  the 
youni,'  women  prisoners  to  estaidish  the  nv/sin;^ 
work,  and  that  the  first  members  of  the  Sistcrhf)od 
were  therefore  rejientant  sinners  wlio  had  taken 
refu.ue  in  the  asylum.' 

This  is  an  entire  mistake.  The  deaconesses 
were  never  drawn  from  the  class  of  prisoners, 
but  were  always  carefully  chosen  from  applicants 
of  blameless  lives.  The  prisoners'  refuj^e  was 
sitni)ly  one  of  the  many  branches  of  loving  service 
conducted  by  the   Fliedners. 

Gertrude  Reichardt,  the  first  Kaiserswerth 
deaconess,  was  the  daughter  and  the  sister  of  a 
physician.     She  was  born  in  Ruhrort  in  1788  and 

•   :\  Pia;.'a/.:iic  artnii',   wiiui  thf  writiTS  iuuc  tint  l>octl  able 

to  itU'iilify,  l)Ut  whii  li  s»H'!iis  to  liaw  hccii  rather  widely  ri.a'1, 
has  I'vidiTit.ly  ])n>]iaj;ati'(i  this  error. 


Kaiscrswcrth  and  the  Deaconess      15 

',v.;s  ;ilrc;u]y  a  \vnm;in  of  m;ituro  yrurs  and  of 
niuch  practical  cxpLTicnce  as  a  nurse.  In  li' r 
fatlu'r's  homo  sr.e  had  bct-n  accustomed  to  assist 
liim  with  drcssins^s  and  operations,  and  durin<^  the 
War  of  Fr(-c-don-.  sh(,  .ia<l  been  his  constant  helper. 
Wlu'n  her  brother  became  a  physician  she  had 
ijained  fnrtlu'r  l;ir,L,^e  exp^'rience  in  the  care  ot  'he 
sick  amon.L,^  his  patients.  She  was  admirably  fitted 
for  the  work  of  the  new  hosi)ital,  and  the  P^liedners 
had  lon.c;  known  of  her  and  for  a  time  had  tried 
in  vain  to  j^r-uadc  her  to  take  up  the  new  and 
experimental  ])ost  of  deaconess.  Finally,  in  the 
early  autumn  thev  had  induced  her  to  come'  and 
ser  the  new  hospital.  It  looked  very  bare  and 
poor  ami  she  could  r^nt  decide  to  remain;  was,  in 
fact,  al)Out  to  return  home  when  a  lar,c;o  bundle 
was  brou^du  in  liy  post,  which  contained  a  (]uan- 
tity  of  new  bed  lintii,  clothin;.,',  and  ward  littinjjjs. 
This  simi-lc  ocmrrence  was  regarded  by  her  as  a 
providential  sii;n,  and  she  promised  to  come  in 
October.  Two  younjf  women  promised  to  come 
;in(l  assist,  thouj^h  not  willin.u:  to  become  deacon- 
esscs.  Gertrude  remainrd  in  the  service  until 
185;  when  she  withdrew  to  the  House  of  F^veninK 
Rest  {Fcii-rabcud  Hatts)  Un-  the  old  Sisters  at  the 
age  of  sixty-eight  years.  Her  experience,  devo- 
tion, and  eharaetei  made  her  an  ideal  pioneer  and 
a  most  vaKuible  aid  to  Frau  Fliedner  in  the  work 
of  training  the  new  Sisters.'     Friederike,   how- 

I  Ciortrudi's  life  was  sketched   in  a  Church  Journal.   Ar- 
»uii  iiird  Kr,utki  iiframJ,  published  at  KaisiTSSNcrth  in  1SO9. 


s 


i6 


A  History  of  Nursin 


(r 
is 


rvrr,  remuine.l  the  head  and  centre  of  the  hospifd 
work.     Pastor  FHedner  writes: 

The   first   <!eaconcss,   T^-h(Mn   wo    I,ad   intended    to 
make  the  superintendent,  and  who  was  a  complete 
tnistress  ot  the  arts  of  caring  f„r  both  b.-dv  and  soul 
"t    her  patients,   nevertheless  had   not  the' rarer  but 
most  essential  talents  of  ruling  and  of  administrati' .n 
Conse(,uently  it  was  necessary  for  mv  wife  to  assume 
the    position    of    superintendent,    and    the    unselfish 
Sister  yielded  the  ruHng  power  wit!,   true  Christian 
selt-abnegation.i 

In    this    first  year   six  r,ther  drae(niess,.s  wen- 
rc.eeived,-Beata.    Johanna.     Helena,     Fran.iska 
Cathenna.   and    '\n.lina.     Sixty   iMtients    in    all 
were  eare<]  for  .,  hospital  an.I  twenty-ei-dit 

'"   'heir  own  homes.     The  visited  cases  were^all 
amonjT  the  poor,  and  most  of  them  were  fiirnishc] 
with  diets  from  the  MMiherhouse.     The  work  w  s 
divided  up  in   this  way:  one  deaconess  did   the 
cooking'  and  housekeeping',  another  had  the  laun- 
dry and  linen  <iepartmeni.  one  the  women's  ward 
-n.'  the  men's,  with  the  aid  of  un  order] v.  and  an- 
other the  chil.lren-s.     They  changed  about  systc- 
macically  and  in  summer  time  one  was  kept  busy 
;n  the  ganien.     Theoretical  and  ch'nical  instruc- 
tion was  ,^nx-c>n  by  Dr.  Thoni.ssen.  who  used    as  a 
basis  I ), .  I  )ic.fTenbaeh's  manual.     The  deaconesses 
also  studied  pharmacy  an.I  passed  the  state  exam- 
ination o„  tins  subject.     At  Christmas  time  Flied- 

'Jahrbuch,  p.  14. 


tal 


to 
etc 
,u\ 

)Ul 

lie 
s!i 
in 


It 


K 


1 


i 


■ 

i 

I 


Kaiscrsvverth  and  the  Deaconess      17 

lUT  in\-iti'<l  Am.'ilie  Sicvcking  to  take  ch;.rge  of  the 
new  work,  in  order  to  release  his  wife  to  her  family 
cares,  but  sliu  was  iinaMe  to  lea\-e  her  work  in 
Hamburg an-i  I-'rieilerike  eontiiuied  as  the  liead  of 
the  establishment.  The  annual  rej)ort  of  that 
jieriod  speaks  of  her  as  fcjllows:  "The  ofliee  of 
Matron  (Mother,  Superintendent)  has  been  filled 
liy  the  wife  of  the  wriur,  wlio  will  eoiuinue  until  a 
suitable  head  has  been  trained."  But  this  time 
'id  not  come;  for,  though  suitable  ones  were 
trained,  they  were  urgently  demanded  in  nc^w 
fields,  and  Fried.erike  kept  lu  r  post  as  House 
Mother  until  her  too  earl_\-  death.  W'aeker,  jialg- 
ing,  from  tlic  man's  stan.ljKjint,  the  wife  as  an 
.aixiliary,  wrote: 

Her  keen  glance  and  pure  and  IidIv  spirit  kejit  liiin 
(Flicdner)  from  making  mistakes.  With  the  \irtuis 
"t  cleanliness,  order,  simplicity,  and  eeondiny  she  li:id 
a  I. •irt,'ediearted  compassion,  great  energy,  and  strong 
rational  sense  to  prevent  the  tnisdirection  of  ministcr- 
::;.U  love.  She  became  a  mo<lcl  to  tlic  deaconesses  as 
v.cll  as  a  mother  to  them.  Her  name  deserves  men- 
tion as  one  who  took  an  important  part  in  tlie  \vork.' 

Thus  placed  in  charge  of  an  untried  undertaking, 
■  lie  pastor's  wife  reflected  often  and  earnestlv  upon 
die  duties  and  responsibilities  belonging  to  it— of 
how  best  to  choose  the  Sisters;  to  train  them  and 
I'lace   them  in  new   jxisitions;  of    their    relations 

'  Pir  Piakonissiit  Hcriif,  KmilWackiT  iCnitiTsloh,  i8SS),  p. 


i8 


A  History  of  Xursin* 


ti)  (inc  aiiiithcr  luvl  to  tlKir  directors.  Slu>  ri'- 
conk'd  her  rrllections  aivl  r^  )nc'lusiMr.s  in  a  small 
volume,  Avhieh  was  k>n.u;  the  j^uicle  for  those  en- 
gajijed  in  the  traininijj  of  deaeonesses,  and  in  all  thi' 
essentials  still  remains  the  accepted  standard  of 
KaisersAverth.  What  a  pity  that  this  \  oUnne,  the 
lirst  work  on  the  trainin.i,^  of  nurses  to  \,c  written 
by  a  woman,  the  fruit  uf  her  practical  ex;)erience 
and  thoui^ht,  fired  by  enthusiasm  and  directed  by 
a  most  able  mind,  should  not  have  been  i,nven  to 
the  iniblic.  It  would  be  indeed  a  classic.  But  we 
may  judj^e  of  its  contents  b\-  the  slatenunt  of  prin- 
ciples later  jiresented  by  Schafer.  The  keN'-note 
of  Friederike's  teaching  was  a  sentence  inscribetl 
m  the  title-page  of  her  note-book,  "  XiciuJini  f^chc 
die  Sclic  prcis  inn  dcr  Juiiist  'wilh-u,"  which  we 
may  transcrilie  thus:  >.ever  sacrifice  the  soul  of 
the  work  for  its  techni(,ue.  Ti'uly,  if  vwrv  wo- 
man made  this  tone  her  own,  no  other  ithieal 
teachini,'  would  be  needed. 

While  Friederike  was  su]ireme  at  home,  pastor 
Fliedner  was  untiring  in  his  exertions  abroad,  trav- 
elling, s]!iaking,  rousing  interest  in  the  work,  and 
founding  new  branches.  The  work  grew  hea\-ier, 
and  Friederike's  letters  often  s])oke  of  an  almost 
crushing  mass  of  duties  and  demands  upon  her 
strength.  Not  the  least  of  thc?e  demands  came 
from  the  many  visitors,  for  now  the  fame  ui 
Kaiserswerth  was  bringing  Inmianitarians  and  ]iliil- 
anthropists  from  far  and  near  to  inspect  the  dea- 
conesses' institute.     One  of  the  most  welcome  was 


% 


Kai^crswcrth  and  ihf  Deaconess      19 


Mi's.  Fr\-,  who  liad  so  slronLjly  influencfil  I-'licdncr 
in  liis  youn.^cT  <kiys.  She  canic  in  M;i\-,  1840,  and 
■■iUhnu.uh  she  spoke  htlie  Oerman,  and  Friederike 
IV  1  l-!!n,tzlish,  these  two  entluisiasts  felt  littk'  need  of 
words,  for  the\'  M'ere  at  onee  eonsrious  of  an  inner 
bond  ^vhich  made  of  looks  and  gestures  a  suOicicnt 
lan.Quage.  Elizabeth  Fr\-'s  approbation  of  rdl  she 
saw  at  Kaiserswerth  rejoiced  Friederike's  heart 
and  ga\-e  her  fresh  eourage,  while  abroad  it  did 
much  to  win  new  friend.s  for  the  cause  and  allav 
prejudice.  An  incident  of  this  d,!\-  which  is  told 
b\-  Friederike's  biographer  is  strikingly  illustra- 
ti\-e  of  her  fortitude,  just  before  Mrs.  I'rx-'s  ar- 
rival she  had  a  letter  telling  her  of  the  death  of 
jxistor  I'liedner's  brother:  but,  unwilliiig  to  agitate 
hi  r  husband  at  the  monient  "i  this  eagerly  ex- 
pected visit,  she  kept  the  sa;!  news  to  herself  with 
tranc|uil  mien  until  the  guest  had  left. 

When  it  is  remembered  that,  in  addition  to  her 
many  luties,  Friederike  w;,s  the  mother  of  a  gnnij) 
o;'  children  (she  bore  ninr  in  all.  but  four  died  at 
birth),  it  is  not  surprising  that  sometimes  e\-cn  h.er 
spirit  sank  under  its  burdeti.      Wrote  Fliedner: 

The  rearing  of  her  cluldron  lirouj^iit  the  tender 
mother  much  j<\v,  and  also  much  anxiety.  Some 
of  the  ehildrc  \  were  delicate,  and  she  could  not  devote 
herself  to  them  as  she  wishe<l.  The  cares  (jf  the  manv 
poor  of  (K  -  parish,  her  share  of  interest  in  the  asvlum 
It  prisoners,  in  the  children's  school  and  the  school 
f  T  teachers  now  connected  with  it,  the  post  of  sujier- 
intenilent  in  the  young  but  yearly  growing   training;- 


20 


A  1  Ii>t()r\-  of  Xiirsini 


scliool  for  deaconesses, — were  im  lii^ht  burdens  for 
luT  to  carry.  Add  to  tliis  the  numerous  \i>itors. 
who  came  almost  daily,  ami  who  usually  stayed  to 
meals.  Xo  wonder  that,  stronj,'  as  were  her  shoul- 
ders and  p;reat  the  coura,!:,e,  the  administrative  talent, 
the  practical  knowleiI.L;e  and  the  skill  with  wliieh  the 
Lord  had  endowed  her,  she  sometimes  proam-d  under 
the  burden  and  asked  if  there  was  not  a  confliet  be- 
tween her  duties  as  mother  and  as  head  of  the  insti- 
tution, and  if  there  was  not  some  way  to  reconcile 
them.  We  talked  it  over  from  every  side  to  see  if  it 
were  not  possible  to  substitute  for  her  in  the  work, 
l)ut  we  could  find  no  way.  Then  she  could  not  but 
realise  how  especially  blessed  her  leadership  in  the 
Work  had  been.  In  the  daily,  almost  hourlv,  neces- 
sary fhrcctions  and  advice,  the  spiritual  eharpe  (jf  so 
many  individuals  and  their  trainin;,^  who  could  be 
so  strono;  a  sujijjort  to  tlie  work  as  she?  .Moreover, 
my  wife  felt  that  the  care  of  the  children  v,-as  not 
only  in  our  hands  but  in  the  hands  of  God.  She  had 
also  before  her  the  reassuring  e.xamjjle  of  Countess 
Zinzendorf,  whose  ability  to  lead  a  life  crowded  with 
jjublic  duties,  similar  to  her  own,  and  vet  to  be  an 
e.Kcellent  mother  to  her  children,  slie  had  always  ad- 
mired. The  develojjmcnt  of  the  deaconess  training 
was  new  to  our  cininh,  and  in  all  the  ruks,  m  their 
dress,  in  their  discipline,  there  was  so  careful  a  line 
to  be  drawn  between  the  extreme  sacrifice  of  freedom 
of  the  cloister  and  the  avoidance  of  a  demoralising 
liberty,  that  the  keen,  Wo.manly  ami  holy  perception 
of  my  wife  was  indispensable  in  avoiding  mistakes. 
The  homely  \iriues  of  cleanliness,  order,  simpli(it>-. 
and  economy,  with  boundless  kindness  for  all  sufferers. 


Kaiscrswcrth  ami  the  Deaconess 


2  I 


■  ■  "i 


S'l  important  for  the  Sisters  in  their  v,-(,rks  of  inen-y, 
w!;'<  else  but  my  wife  nmld  icnh  and  enlnne 
lliem  rightly?  Then  the  maseuline  energv  which 
she  pussessed  and  the  way  in  v/hich  she  euuld  control 
and  subdue  WronLjdoers  and  pirxent  imjjosition — this 
united  with  her  nati\-e  .s^'cntleness  made  an  e\traur- 
(Unary  eombination  of  eharacter. ' 

So,  tor  thi'  sake  of  the  work,  iM-iederike  con- 
tinued to  liear  th<' douMe  lairden.  Tlie  vcars  1S41 
and  1842  were  full  of  family  affliction.  }\vr  hus- 
liand  and  thn-e  of  her  children  were  jirostrated  l>y 
severe  illness,  and  as  they  slowly  jjassed  the  danger 
line  the  time  came  when  an  en.<^'a,y;emcnt  ])reviously 
made  to  orL!;anise  the  nursing;  work  in  two  other 
C.erman  cities  had  to  be  met.  Fliedner,  almost 
convalescent,  was  entirely  inilit  to  <^^o.  The  cir- 
cumstances were  urgent,  lor  the  need  was  \-er\- 
great,  and  Friedcrike,  faithful  to  her  responsibil- 
ities as  head  of  a  nursing  (jrder,  put  her  younger 
.-'.sier  in  charge  oi  Ikt  sick  children  and  prepareil 
for  the  journey. 

"  What  it  must  have  cost  her  to  tear  herself 
away  from  her  lo\-ed  ones  onl\-  the  heart  of  a 
mother    can    know!"     She    took    with    her    four 

leaconcsses  to  begin  the  new  work.  The  condi- 
tions she  found  were  horrible:  they  were  the 
conditions    generally    prevalent    in    hospitals    at 

:iat  time,  and  give  a  realising  sense,'  of  the  Augean 
stables  which  were  cleaned  by  the  labours  of  the 

>  Kurzer  Abriss,  pp.  75-76.     Jahrbuch.  pji.   iS-iq. 


A  IIi^^tc)r)•  of  Niii^in^ 


r 
ft 


fuiLht'ul    (IcicoiKSScs.     I'-ririlcrikf    wrolr    io    bcr 
lin>lianil : 

Ai    nine    nYldck    the    dircrlnr    and    secretary    ac- 
companied us  to  the  hnspitah      I  was  often  si.  nause- 
ateci  at  wiiat  I  saw  1  had  to  run  to  the  window  -  - 
the  tilth  and  vermin  were  indescribable.     The  haunts 
of  thieves  could   be  no  worse.      A   wuman   has  been 
here  since  183S  who  is  not  yet  cleansed  irmw  vermin. 
The  doctors  make  rounds    certainly   not   too  often. 
Thev  were   here   yesterday.     A   drunkard   whu   had 
tried  to  ctit  his  throat  was  ]>roposed  tn  me  by  the 
committee  as  an  attendant  for  the  sick  -I  declined. 
The  inventory  is  to  be  Ki^'<-'ii  us  to-day.      .M(jst  of 
the  beddinj,'  will   ha\-e   to   be   draj^^ed  with   pnjn^s 
and  tonus  to  the  stable.     We  will  d^  this  on  Munday. 
To-<lav    the  Sisters  with  a  scrub-Woir.an  are  cleanin,u 
the  niom  into  which  we  will  r.i.  )ve  to-niwrnAV  cveninjj, 
Sund^ay.     I  would  hke  to  slay  here  several  days    to 
relieve  the  d.reariness  for  the  Sisters,  ,iret  the  male  at- 
tendant .grounded  in  his  wcjrk  and  have  smne  rooms 
citUK    ,      The    whole    committee    is        min<,'    to    the 
h.osj)ital  t<.-day  at  four  o'clock,  and  I  must  meet  them. 
I    ha\e   t<ild    tl;e   directors    that   if  conditii.ns   are 
nut  altered   we  will  not  allow  the  Sisters  to  stay  .   .   . 
f'lr  they  shall  not  kill  themselves  working  for  nothing 
.   .   .    and   in    such    dens   of   immorality   they   could 
accomplish  no  tiling. 

I  wish  I  could  write  a  description  of  the  glorious 
mountains  for  my  beloved  children,  but  I  must  hurry. 
I  have  much  to  do  and  little  time  tw  write.  God 
bless  you  and  the  dear  l.iyal  Sisters  witlmut  wliom 
we  could  do  nothing  of  all  this.  Oh.  my  beloved 
Hannah    [the    youngest    of   the    sick    children],  how 


Kaiscrswcrth  and  the  Dcacoiu'ss 


1  ■> 


l";iin  would  I  lit-  with  Xhcv,  dearest  life  it  eanivit  ],v  — 
1  must  rcnouiuo  niurh  — the  \."vd  j^ive  me  a  willing 
heart— I'^'t-r  thy  Friederike.' 

Friedcrikc  rettirncMl  \vnv.c  to  find  lh;it  onr  of  the 
chililrcii  h;ul  had  .l  rclaiisc  and  was  K"ne  iVoin  her, 
and  a  iVw  <l:Lys  later  the  httle  Hannah  also  died. 
This  double  loss  inspired  the  mother  to  lur  h.st 
work,  the  fotmdin;^  of  an  asylum  for  (.ir])hans. 
She  had  often  thou.^ht  of  it,  and  now  one  da\-  she 
brouLiht  in  two  motherless  ehildrei;  and  made 
them  at  home  with  her  own  remaining  little  ones. 
From  this  be.yinnint;  i^^rew  the  many  or[)hana;4es 
of  Kaiserswerth. 

Friederike  was  ncjw  at  the  end  of  her  labours; 
she  could  bear  and  do  no  more,  and  on  the  jjnd  of 
Ajiril,  1842,  after  a  few  days'  illness,  she  ,u'a\  e  pre- 
mature birth  to  a  dead  infant,  and  breathed  her 
last.2 

She  died  the  first  [wrote  Fliedncr]  of  all  the  doacon- 
c-ss';'^:  as  ;'-.  ,  the  Mother,  was  in  all  thinps  the  leader 
amon^'  her  spiritual  daughters,  so  sh,c  went  bet' to 
them  in  death.  How  this  i.;reat  vuid  is  to  be  tilled 
is  knnwn  only  to  (iod. 

The  historical  disappearance  of  Friederike  and 
the  eoinplele  identification  of  pastor  Fhedne'- 
with  all  of  her  creative  and  executive  work  is  a 
characteristic  example  of  the  way  in  which  the 
woman's    share   of    the    world's    work    has    been 

^  Jahrbiich,  pp.  21-22. 
» Ibid.,  p.  24. 


24 


A  History  of  Xursint;' 


1 


generally  ij^norcil.  Numerous  and  copious  arc  tlif 
books,  pamphlets,  essays,  and  mai^azine  arlieks 
on  llie  Kaiserswerth  revi\al  of  the  deaconess 
order;  yet  rarely  is  Friederikc  e\en  alluded  to. 
All  is  attributed  tf)  her  husband,  even  those  details 
of  the  av.tual  nursing  organisation  and  training 
which  he  himself  has  expressly  stated  were  her 
own.  Pastor  Fliedner  is  to  be  exonerated  from 
any  share  in  this  historical  injustice.  His  own 
part  in  the  work  was  sufficiently  important,  with- 
out taking  hers,  and  in  describing  their  purposes 
and  efforts  he  always  said  "we."  It  has  come 
about  from  the  unconscious  vanity  of  subsecjucnt 
pastors  wlio  undertook  in  their  turn  similar 
organisation,  that  the  composite  picture  called 
Fliedner  has  been  drawn,  and  copied  thoughtlessly 
by  scribes  of  alt  nations.' 

For  a  year  they  groped  on  alone;  the  Sisters  did 
their  best  to  share  the  burden  laid  down  by  Frie- 
derikc.    To  make  administration  easier,  Fliechier 


I  The  rediscovery  of  Friederike  w.is  due  to  the  intuition 
of  Mrs.  Bivlford  Fenwitk,  an  Kn^lish  nurse  ;ind  writer,  who 
first  sit  'II  foot  the  inejuiries  which  brouRht  her  real  share  in 
the  deaconess  movement  to  h^ht.  At  the  Berlin  mcetinR 
of  the  International  CoMncil  nf  Women  in  11)04,  Mrs.  Fenwu-k 
stated  Friedcriki's  eniinenr-e,  which  ha'i  lieen  forgotten  even 
in  Gennany,  and  she  first  gave  an  English  translation  of  her 
life  in  the  Hritish  Journal  of  X liming.  May  a6,  i()o6.  et  srq  . 
called  "  Fricdirike  Fliedner,  the  first  Superintendent  of  the 
Deaconess  Institution  at  Kaiserswerth,"  translated  by  Miss 
L.  Metta  Saun<lers:  taken  from  Pastorin  Frkderikc  Flicdiwr: 
die  erste  Vorslrlifrin  dcr  Diakouissen  Aitslalt.  .\r»uun>td- 
KranhinfrcHnd,   iS;i, 


■ 


m 


I'riiclcril  e  l'h> 


tliHih 


II r  c  iin  ■ :  I,- 


[  'ill, 


W  II  ill.   I  ■ 


Kaiscrswcrth  and  the  Deaconess 


-D 


lormed  a  conference  of  all  the  older  Sisters,  at 
which  they  took  counsel  to<];cther  as  to  the  conduct 
of  the  estabhshment.  Even  although  the  main- 
stay was  gone,  the  work  had  to  go  on.  The  King 
of  Prussia.  Frederick  William  IV.,  was  j/lanning 
a  deaconess  house  for  Berlin,  which  Fliedner  •'■■as 
to  start.  Again  he  went  to  Hamburg  to  see 
.•\malic  Sieveking,  and,  as  has  been  already  told, 
through  hiT  he  met  her  friend  Caroline  Bertheau, 
who  was  in  charge  of  the  nursing  dei)artment 
in  the  general  hoLpital.  A  second  time  in  seeking 
a  superintendent  for  his  work  Fliedner  fountl  a 
wife,  and  again  one  as  capable,  as  devoted,  and 
as  self-forgetting  as  the  first.  Caroline  married 
him,  took  charge  of  his  household  and  motherless 
children  together  with  the  whole  large  and  rapidly 
growing  deaconess  establishment,  and  brought 
up  eight  children  of  her  own  as  well.  She  sur- 
vived him  long,  for  pastor  Fliedner  died  in  October, 
1864,  after  strenuous  and  increasing  labours,  but 
I-Vau  Fliedner,  truly  "Mother"  Fliedner,  re- 
mained for  almost  twenty  .ears  after  this  the 
head  and  heart  of  the  whole  work,  assisted  ably 
by  her  son-in-lav>,  Dr.  DisselhotT. 

On  their  wedding  trip  pastor  Fliedner  took 
her  to  Berlin,  where  the  Kaiserswerth  Sisters  had 
just  been  i)laccil  in  charge  of  the  venereal  wards 
of  the  Charite.  The  work  was  new  to  them  and 
had  come  about  as  the  result  of  a  report  which 
Fliedner  had  made  to  the  Princess  Marianne  and 
the  Queen,  of  the  horrible  abuses  then  prevalent 


26 


A  Ilistorx  of  Xl  sini 


in  every  jiartment  oL  ihc  old  city  hos])il;il. 
Pastor  FlicdntT  was  \cry  anxious  about  this  pio- 
neer reform,  and  Caroline,  having  had  experienee 
in  a  similar  ser\iee  in  Hamburg,  went  st night 
into  the  wards  with  the  Sisters  and  wt)rked  with 
them  until  their  way  was  smoothed  out  before 
them. 

Let  us  pause  here  for  a  glanc"  at  the  old  hos- 
pital, the  seene  of  Caroline's  honeymoon. 

( )ne  of  the  famous  hospitals  of  the  world,  though 
nnt  so  ancient  as  many  others,  is  the  Charite  of 
Berlin,  long  a  noted  centre  for  medical  teaching. 
It  has  also  had  an  interesting  and  instructive 
(though  not  admirable)  nursing  history,  and  is 
distinguished  as  one  of  the  hospitals  where  nursing 
reforms  in  modern  times  were  first  attempted. 
If  it  cannot  be  said  that  these  were  succcssfu! 
at  least  the  credit  of  the  attempts  belongs  none 
the  less  to  it.  Originally  a  pest-house,  .Tccted 
during  the  spread  of  the  plague  in  1709-17  lo,  l)y 
King  Frederick  I.,  at  his  own  expense,  but  not 
actually  used  as  such  because  the  ei)idemic  did 
not  reach  us  far  as  Berlin;  then  a  workhouse; 
ne.xt  a  lazaretto  or  military  hospital,  with  some 
wards  also  for  civilians,  not  until  1727  did  it  receive 
the  name  of  the  Charit(f'.  Frederick  William  linn 
endoweil  it  ami  devoted  it  to  educational  purposes. 
In  17.^7  its  internal  organisation  was  regulated  and 
its  six  divisions,  the  military  wanls,  medical  and 
surgical  ci\il  departments,  syphilitic,  obstetrical, 
and    skin    departments,  were   svstcmatiscd    v.ith 


Kaiscrswcrlh  aiul  the  Deaconess 


I 


■hv  double  ])urpose  of  charity  and  instruction. 
it  hail  then  200  b^.^ls.  The  attendants  were  nun 
and  women  of  purely  secular  character,  and  il- 
literate. For  every  small  medical  ward  there 
was  one  woman  attendant,  and  for  two  surgical 
wards,  one. 

Tlie  whole  edifice  was  rebuilt  in   rjH^.  and  the 
isylum  for  the  insane  added  to  it. 

The  nursing  (]uestion  was  early  considered  and 
die  necessity  for  raising  the  standard  recognised. 
The  exjx-rimcnt  of  improving  the  food  and  the 
pay  was  tried;  the  discipline  was  military,  and 
the  wards  were  imi)roved  in  some  respects. 
In  iSjjo  the  Krankvmcdrtcr  Sdiulc,  or  course  of 
instruction  for  attendants,  was  established.'  As, 
liiA\-e\-er,  the  whole  nursing  system  was  wrong 
'.ndanientally  ami  throughout,  the  results  could 
not  Im.'  good. 

For  some  fifty  years  after  the  first  entrance  of 

the  deaconesses  into  its  wards,  the  Charite  was 

nursc'l  on  a  plan  which  seems  to  us  clumsy  and 

)m[)licated.     Beside   its   own   nurse-attendants, 

it   engaged    groups   of   deaconesses   for   the   care 

f  special  wards.      If  one  Motherhouse  (as  was 

:ien  the  case)  could  not  sup])ly  enough,  another 

lie  was  a])])lied  to,  and  thus  in  time  groups  of 

:  arses  from  several  training  institutions  or  Mothcr- 

ious(>s  were  on  duty  at  the  same  time  in  ditTerent 

iivisions  of  the  hos])ital,  each  group  being  under 

i\vn  supervising  Sister.     There   w  as  no  one 

i)niij/()i  dis  Charite   Krankenliaus  :u   Hcrlin,    iSso. 


'% 


28 


A  1  lislory  of  Xur^iiiL. 


woman  head  for  these  (Hfferent  <,'roups,  but  tb.ey 
h\eil  toi,'ethtT  as  separate  famiHes,  each  under  tlie 
fnial  control  of  the  institute  which  sent  them. 
One  can  hardly  imagine  a  more  effective  wa\-  of 
pnn-entint^   unity   of   administration.' 

Mother  Caroline  Fliedner  was  a  character  of 
great  force  and  sweetness.  She  was  describeu  as 
"a  joyous  child  full  of  gaiety,  of  strong  will,  and 
with  great  consideration  for  all  around  hcr.^  She 
was  of  a  Huguenot  family  that  had  been  exiled  in 
1683  from  France  and  had  settled  in  Hamburg. 
She  was  born  in  iSii  and  had  been  educated  by 
Amalie,  who  delighted  in  training  young  girls 
to  have  ideals  of  social  usefulness.  She  had  been 
])erusadcd  by  her  preceptress  to  enter  the  General 
hospital  to  conduct  a  reformation  in  the  nursing, 
and  had  been  at  work  there  for  three  years.  I  )ur- 
ing  her  long  administration  of  Kaiserswerth  lur 
great  energy,  practical  ability,  and  genuine  char- 
acter commanrled  the  resi)ect,  admiration,  and 
love  of  all  "  from  high  to  low."  It  was  said  of 
her  by  a  pastor  that  whenever  difficult  i)roblems 
came  before  the  management,  and  she  \\-as  called 
upon  to  give  her  opinion,  she  always  waited  long 
before  speaking,  but  that  when  she  spoke  "her 
words  were  so  direct,  her  reasons  so  convincing, 
and  her  solution  of  the  difficulty  so  simple  that 


'  At  the  pn-scnt  time  the  Charity  is  establishing  a  trainiii),' 
school  un  modern  lines,  or  at  least  making  the  attempt. 

'  Mutter  h'lUdner:  zuni  Gcdachtnisi.  Kaisersiverth  a»i 
RItein,    iSgi. 


Kaiscrswcrth  and  the  Deaconess      ^^9 


all  iiistcUitly  agreed  %vilh  her."  '  She  gave  up 
the  work  in  1884,  but  Uve'l  ten  years  longer,  her 
!iiiii'l  keen  and  alert,  her  heart.  ;is  warm  as  ex'er. 
The  annual  reports  during  the  lifetime  of 
])astor  Flicdncr  arc  full  of  side-lights  on  the  nursing 
work  of  the  Motherhouso.  The  "Mother"  or 
Superintendent  is  often  spoken  of  as  directing  all 
■he  work  and  tlcveloping  new  fields.     As  early  as 

he  fourth  report  the  need  of  better  pre})arator}' 
iducution  for  the  jjupils  has  been  felt,  and  the 
iiope  is  expressed  that  in  the  coming  year  some- 
thing may  be  done  to  fill  this  want.  In  this  report 
•  ilso  Mrs.  Fry's  visit  is  mentioned  and  joy  expressed 
at  having  heard  from  her  of  the  beginning  of  her 
own  ■'  Xursing  Sisterhood"  on  her  return  to  Eng- 
land. In  the  fifth,  mention  is  made  of  several 
pupils  having  been  sent  from  France  and  Switzer- 
land to  be  trained  at  Kaiscrswcrth.  It  was  from 
the  outset  regarded  by  the  fdiedners  ;iS  most 
desirable  and  important  that  room  should  l)e 
made  for  and  o])portunity  given  to  persons  desir- 
ing to  come  for  a  time  to  study  the  methods  of 
Kaiscrswcrth. 

In  vitv.  of  this  well-known  attitude  of  pastor 
idiedncr  an<l  his  wife  toward  students  who  might 
help  in  spreading  the  new  system,  the  story  some- 
'imes  told  that  pastor  Flicdncr  at  first  refused  to 

'insider   Miss   Nightingale's   application,   on   the 

'  From  l.ifr  nf  Pasfnr  Flifdncr,  tran^j^nt^d  from  tho  rrormnn 
•'-  Catherine  Winkworth,  \.<m<\(m,  iShy,  p.  85.      Autliorisid 
s  family  and  published  in  Kaiscrswcrth,  1866. 


30 


A  History  ui  Xui^mg 


<,'r<)un(l  thut  she  was  too  rrfini'd  and  dcliraU', 
and  that  W  re-iuiml  \vv  to  -ct  dcAvn  and  se-ruh 
a  floor  before  admitting,  her  to  trainin.u,  seems  a 
Httlc  apoeryi)hal.  No  doul.t  she  had  to  sernh 
floors— that  was  part  of  the  work. 

Ill  thi>  sixth  report  the  probation  time  has  been 
developed  by  ])lacin;^  a  teaehin<,'  Sister  in  speeial 
charcre  of  the  probationers,  ^vho  now  ha\e  a  hall 
to  themselves  and  are  taut,'ht  and  prepared  for 
their  duties.  The  orphanage  has  V>een  started, 
and  ehildren  of  respectable  families  are  to  be 
l^iven  a  good  plain  education,  and  allowed  to 
sileet  their  callin.^s.  It  is  hoped  that  some  will 
be  attracted  to  the  nursing.  Plans  for  district 
nui-sing    {(icmciuikpflcgc)    are   now   projected. 

The  eighth  re])ort  speaks  of  the  successful  plant- 
ing of  district  nursing  worK  in  tv/o  parishes,  Biele- 
feld  and  Cleve.  in  the  previous   year,    and    this 
extension   is  regarded  with  the  fondest  hope  and 
jov.     vSeveral  years  later  Cologne  and    IdlRilVld 
have  district  nursts.      In   the  morning  they  i>re- 
l)are  nourishment  for  a  number  of  poor  and  sick, 
and  in  the  afternoon  they  visit  and  nurse,     b, 
Clcve  the  two  district  nurses  have  a  little  honie 
hospital,    and    receive    there    several    very    sick 
])atients.     They  have  also  under  tluir  charge  a 
school  of  sewing  and  embroidery  for  destitute  girls. 
At  this  time  pastor  Fliedner  speaks  of  having  to 
refuse  to  permit  the  district  nurecs  to  do  night 
-lutv.     He  has  now  had  to  give  u]i  chureh  and 
parish  and  devote  himself  entireh"  to  the  business 


"  Mother"  (.'arolinc  KlicdiK-r 
111     yi///;-/',7,V/     /»;•     ChriUli.lh'      i'lit.rlhutiiii^ 


Kuiscrsucrth  antl  the  Deaconess     ji 


of  (levclopinLT  the  district  \vf)rk.      In  the  ,L^ro\\lh 
of    the    Molhcrhousc    there    i:^     now    ;i    I'robc- 
SchuTstcr  (the  "Home  Sister"  of  the  later  English 
schools)    in  charge  of  the  probationers,  and  t\vo 
teaching  Sisters  ^vho  gi\e  them  instruction.      In 
1S50  menliini   is  made  in  the  reports  of  several 
Sisters  sent  to  pastor  Passavant  in   I'ittshurg,  in 
far-off  America,  whither  Fliedner  himself  had  jour- 
neyed with  them.      There  had  been   ty])hus   and 
cholera  epidemics,  and  tlu'ir  record  was  admiral  >le. 
Thi'V  had.  ho]ieil  to  establish  a  deaconrss  Mother- 
house,  but   only  one  ])robationer  cami'.       Piistnr 
Passavant   begged   for  more  Sisters  to   be   sent, 
even  offering  to  pay  all  their  expenses;  but  Flied- 
ner refused,  saying  that  he  had  given  them  enough 
deaconesses  to  teach  and  train  a  new  set,  and  they 
must  findi  tlu  ir  1  iwn  ])ri  '\  latioiters.     The  need  of  the 
deaconesses'  work  in  the  United  States  was  the  sub- 
iect  of  many  discussions  in  Lutheran  synods  of  that 
year.     In  this  report  also  (1850)  Miss  Nightingale 
is  mentioned  as  having  come  for  some  Nweks,  also 
a   Swedish  and  a  Russian    lady.       In    1S5O    Miss 
Nightingale  is  again  mentioned.     She  had  given 
the  Constantino|)le  Deaconesses'  hosjiital  thirteen 
lieds  and  enough  liiun  for  forty  patients.     The 
twentieth  annual  report  is  signed  by  a  committee. 
Pastor  Fliedner  is  tra\elling  in  the  Fast,  partly 
inspect  the  liranch  houses  .and  ]>artly,  luit  in 
.  ain,  trying  to  shake  oif  the  ill-health  to  ^^hi(■h  lie 
finally  succumbed. 
The  principle  on  which  the  I'lieilners  based  their 


32 


A  History  of  Nursing 


work   and    that    of    tlu'    newly    re\ive(l   order   of 
deaconesses  was  that  of  joyful  ser\iee  springing 
from  self-sacrifieing  lo\e,  the  old,  old  idea  of  the 
salvation    of    the    world    throu,L;h    the    nii.i^dil    of 
regenerating  lo\c— interpret nl  after  one  manner 
l)y  the  doetrin.dres,   after  anotlur  h\-  ])Ofts,   art- 
ists, and  musieians,  and  still  anotlur  bv  thousands 
of  ol)Seure   hearts.     Theirs  was    a    l-eautiful    and 
a    henefieent    purpose.     Indirectly,    viewed   from 
the    moilern    standpoint    of    the    ])rogress    so    far 
made   toward    the   tnianeipation    of    women,    the 
revi\-al  of  the  evangelical  deaconess  order   was  a 
most  important  and   significant  movement.       It 
was  the  first  step  in  a  slow  series  which  had  to 
be  taken  to  release  women  from  the  narrow  and 
cramping  social   bondage   in   which,   unless   thev 
had  independent  means,  they  wire  held  at  that 
period,— a  period    whieh   did   not   educate  them, 
which  hardly  all^.^'ed  them  to  earn  their  li\-ing 
unless  they  belonged  to  the  lowest  social  ranks, 
and    whit'h    permitted    them   little    or    no    inde- 
pendence   or    initiative.     Althou.gh    hers    was    a 
strict  and  in  many  respects  a  narrow  discipline 
the  deaconess  was  far  freer  than  her  sister  the  nun, 
and  had  a  more  natural  life.     Though  she  was 
only  supported  and  not  jxiid,  this  was  nevertheless 
a  tremendous  ad\'ance  over  being  jiermitted   no 
occupation.     The  deaconess  mo\emcnt   supj)lied 
the  first  great  general  school  for  iniproving  the 
practical  training  of  Protestant  W(^men  for  useful 
work,  andi  was  the  pioneer  in  bringing  to  a  highly 


kai^LTSucrlh  aiul  the  iJcaconcs; 


JO 


'onscrvr  'vc  and  narrow  social  ohUt  the  idea  that 
vvcvy  form  of  labour  was  honourable  and  dignified. 
I'astor  Flicdner  himself  summed  u])  the  essentials 
of  organised  life  as  de\-eloped  in  Kaiscrswcrth  as 
follows : 

In  organisation  t lie  w  irk  was  a  free  rcl'gious  as- 
sociation, not  depondcnt  on  state  or  >  Imr:  h  auihori- 
ties.  It  takes  its  stand  on  the  mother  nature  ut  the 
I  hurch  founded  by  Christ. 

Two  errors  Were  avoided:  i.e.  i.  Conventual  \m-ws 
'ir  a  eontcmplative  aseetie  character,  and  2.  dvccn- 
tralisation.  The  Kaiserswerth  deaconesses  after 
live  years  of  ser^-iee  were  to  be  free  to  return  home  or 
t'l  marry.  The  .^bnherhouse  is  a  democratic  family 
and  the  deaconesses  have  a  voice  in  choosing  their 
superiors  or  heads.  The  Motherhouse  must  be  a 
jinjtection  and  home  for  all  the  members,  so  it  retains 
final  authority  over  all  members  in  outlying  places 
and  the  right  to  call  them  back. 

The   work  is   regarded   as   in   four   branches   with 
sub-branches: 

I  acute 
Hospital  <  chnmie 

.\.  Xursing   \  ,,.  .    (  ^P^'^'i^' 

lrr."ate  nursing 

Parish  or  district,  i.e.  visiting  nurs- 
ing. 
Orphanages 

Homes  for   aged  and   infirm 
Distribution  of    sewing   and 


B.  Relief  of  Pour 


handwork 
Almshouses 

Asylums    for  the  blind,  etc. 
Training  homes  and  bureaus 

tor  servants. 


VOL.  II.— 3 


34 


A  History  of  \ursin<; 


j'Schof)ls  ff)r  little  children 

j  Schocils  for  girls 

/^     I'  ,      f /.,  •,  1  I  Training  schools  fcr  ♦cachcrs 

L.    C  are  ci  Lhildren       ,,  .'^^     .    .  ,      , 

.Manual  tr'iinmi;  schools 

Si>crial    tcachin.i,^    for    insti- 

[  tutidns  f(jr  the  Mind,  etc. 

T^    Ti-    1  T-    4-    .        .     IT-  (  Prisoners 

I).   Work  ainunir  Lntortiinatc   utuieu-  ,,      ,   , 

(  Ma.u'dalens 

Pastor  inieiiiK-r  \s'as  a  truK'  rt  niark;;lil(>  man: 
— ,<,Teat  in  his  larujc  licart.  his  true,  U'rM.nt,and 
simple  \>\v\\  .  his  \ast  eiUTij:\-  an'i  practical  et'li- 
ciencv.  Xo  man  h.td  more  ideal  heljjtrs  in  his 
two  wi\-is,  hut  he  deserwd  them,  fi  t  he  jilaccd 
women  hii^'h,  recos^rnised  theii  abilities,  and  wil- 
inj^ly  accorded  thent  full  authority  in  their 
domain.  Ke  was  one  of  the  first  to  advocate  the 
introclucti"!!  of  wonien  as  teachers  into  the  p..  )lic 
schools,  aj:;ainst  which  tlure  was  then  a  strong 
conservative  jirejudice,  and  he  establishid  a 
normal  school  for  .^irls  as  one  of  the  Kaiserswerth 
institutions.  The  striking  feature  of  the  Kaisers- 
werth administration  was  the  wise  and  humane 
treatment  of  their  inmates  as  indixdduals.  In  the 
intelligent  use  of  occupation,  diversion,  and  cheer- 
fulness they  were  far  ahead  of  their  time.  The 
amusements  and  instruction  of  con\alescent  chil- 
dren, adults,  and  defectives  were  early  thought 
out  with  care  and  wisdom.  The  children  were 
taught  reading,  writing,  accounts,  singing,  story- 
telling, and  organiseil  play.  The  older  patients 
were  taught  a  number  f)f  hand  industries,  such 
as  knitting,  net-making,  weaving,  and  lx)x-making, 


I 


Kciiscrswcrtli  and  the  Deaconess 


j:) 


and  h;ii'  li.^'hl  \VMrk  in  llic  ,u;;r'lcii.  IlliUTalc  vnn- 
vak'scciits  w^Tc  tau^hl  n-adinj;  aiTl  writiii^^  .aid 
sintjin^'  was  re.^ardcd  as  a  universal  necessity. 

The  formal  eliarter  of  incorporation  for  the 
Kaiscrswcrth  Deaconesses"  Institution  had  Ixen 
granted  by  a  ministerial  order  on  Xovcmhcr  20, 
1846,  ten  years  after  the  l)e.trinnin,i,^  of  the  work, 
and  an  afliliation  of  Motherhouses- which  were 
either  or<,^anically  related  to  or  in  full  svini)athy 
with  it  and  so  desirous  of  sui)i)ortin^f  and  heinj^' 
supported  by  it-  -was  a  further  effort  of  Fliediier's 
ort,'ani:  inj^  K'^'^ius.  This  afidiated  body,  called 
the  Kaiserswerlh  (ieneral  0>nference  of  Mother- 
houses,  meets  lneiuii:ill_\-  at  Kaiserswirth  ,ind  i»s 
rep(jrts  show,  as  pastor  ( ioMcr  writes. 

the  cxceedinj^ly  Rrcat  scope  of  activity  in  an  army 
nt  m(»re  than  thirteen  thousand  dcacencsses.  There 
i<  no  kind  of  human  misery  that  it  does  not  reach. 
Tliey  serve  with  loving'  liearts.  wise  discretion,  and 
skilful  hands  the  sick  of  every  condition— epileptics, 
the  imbecile,  lepers,  and  lunatics:  neijlected  children 
and  abandoned  infants;  the  crippled,  a^ed,  fallen 
w>tnen;  incarcerated;  orphans;  servants  out  of  em- 
])l')ynicnt;  unattended  children;  youn-;  j^'irls,  and  a 
mimbcr  of  others  in  need. 

It  is  impossible  not  to  be  struck  with  the  general 
nscmblanee  between  the  deaconess  movement 
Jtnd  that  of  the  'Msters  of  Charity,  and  by 
certain  features  in  common  in  the  characters  of 
\'incent  de  Paul  and  pastor  Kliedner.     Different 

•heir  personalities  were,  both  were  alike  in  the 


36 


A  History  of  XursiiiL;- 


m 


rare  simplicity  ami  luiniilit\-  of  lh>  ir  unaffected 
])iety;  in  their  e(Miii)lete  self-ffir^elfuhn  ■,  their  un- 
iinfiaL,'gin,^  ami  aetiw  cont'ii-n  for  human  misery ; 
in  their  inmiense  ener,i::y,  in  their  orq'anisini;  e'  1 
administrative  ability.  Tln'se  two  men,  iikc 
Lambert  le  'Rri^aie,  knew  how  to  eall  '  mh  and 
develop  useful  initiative  in  the  .nasst-s  around 
them;  how  to  foeus  and  .i^nhiie  it.  Their  i;reat 
secret  of  manaj^ement  lay  in  a  eomi)letc  absence 
of  repressive  t'oree.  They  perpetually  encouraged 
an  .  never  dis(.'oura:.,'ed  the  ciTorts  of  others.  In 
the  (-[reat  movements  of  human  aeti\ity  vith 
\\hich  their  names  are  assoeiated  they  de;.h  with 
vvomrii  and  men  on  the  same  plane,  showini^  the 
former  the  same  rt  speet  anrl  consideration  as  the 
latter.  In  a  word,  the>r  eminent  men  were 
cntirelv  free  from  all  narrowness  or  caste  fcelinp. 
The  WDineii  m  tlusc  two  ,uriat  mo\rn.ints, 
th'n;;j;h  some  had  social  stati'iu  and  education, 
were  alike  recruited  larj,'el\-  from  the  pea.sant 
classes:  alike  they  taui,'ht,  toiled,  rcseued,  \isited, 
a!id  nursed,  and  in  war  foll()We<l  their  country's 
fla.i^.  Thou.^h  arrayed  under  d.'ifdvnt  re  li.t^ious 
f.irmukis,  these  were  essentially  the  same  women, 
animated  by  the  same  si)irit  a. id  enjoyin}.,' alike  die 
love  and  ri'^'i"''!  "'  '''"''  people.  The  Kaisersw(Tth 
deaconesses,  like  the  SistiTS  of  Charity,  were 
always  on  the  spot  where  there  was  pestilence  or 
misery,  b  1848,  when  the  hunger  tyjihus  deci- 
mated Altdorf,  they  were  there,  and  in  1840 
thev  nursed  the  cholera  patients  in  a  numlier  of 


Kaiscrswcrth  ainl  the  Deaconess     37 


small    towns.     After    the   \v,tr  of    18O4  sniall-pox 

Irokcout  both  ill  hdSjMtals  ami  in  touiUi-y  re.uions. 

The    (leuconcsses    found     the    ])easants    in    their 

cottages,   often  witliout  lie^ls.dn   the   floor  or  on 

i)iles  of  straw  eowred  \vith  raL^s,  while  the  eows 

and  pigs  iiihabiteil  a  part  of  the  dwelling,   or  a 

<,T()U])  of  fannhands  shared   tlu'  siek-rnoni.      For 

nearly   twn   vears   the_\-  struu.uled   with  sinall-p(jx 

iin<ler  sueh  eonditions,  caring  for  more  than  1000 

eases  in  all.     Tlien  war  1  in  ike  otit  again,  followed 

hy  cholera,  whieli  swept  tlie  kiral  in  a  wa>-  hitherto 

unknown.     Thirty-live     deaconessrs     worked     in 

more  than   twenty   loealitits.    nursing   over    1000 

patients,  and  as  'he  cholera  dici  away  true  t\-])hus 

fever  brt)ke  tmt  ni  l:ast  Prussia,  and  eight  of  the 

deaconesses  hastened  thither  to  the  ])estdiouses. 

TheU'after  there  was  hardly  a  period  when  some 

of    the    Sisters    were    not     cani])aigning    against 

contagion,  and  when    the    al.irnnng   ejMdemic  of 

cholera   raged    in    Hamburg,   in     iS()-',    tifteen    (jf 

their  number  went  to  the  C.eneral  fity  Ilospit.d, 

where  they  worked  night  and  du\-,  in  tlie    wry 

Wards  where  their  second  mother,  Caroline,  had 

served  as  a  \olunleer  nurse  in  her  \'outh.     As  in 

epitleniics,  so  in  the  wars  of  iSdi,  iS(>.i,  iSdO,  and 

1S70   to    1871,  the    deaconessts    of    l\.aiser>wi  rth 

Acre    consjiicuously    active.     They     served     not 

only  in   the  hospitals,  but  on  the  very  fields  of 

battle,  and,  acct)nii)anie(l  by  a  guard  of  Uhlans, 

Miey  followed    the    Prussian   army   in   every   ad- 

aue.      In  all,  they  served,  in  1870,  in  more  th.m 


S 


iB 


3B 


.\  History  of  Xursini;' 


si\ty  niilitury  liosjiitals,  and  over  30,000  soldiers 
jiasscd  throus^h  their  wards. 

Beside  its  imnierous  intei^Tal  branches,  Kaisers- 
wcTth  at  dilTeri'iit  times  organised  an('  j^ave  over 
into  other  liaiuls  for  independent  nianaj^enient 
no  less  than  ;()  different  institutions,  34  of  which 
Wire  hospitals  and  0  deaconi  ss  houses.  After  the 
successful  dunonstration  ot  the  I'diedners  there 
was  a  Lieiieral  nioxcnient  oi  aeti\e  imitation,  and 
not  a  year  passed  that  new  .Motherhou.scs  were 
not  estalilisned.  The  hosjiitals  wliieh  tlie\'  erected 
set  a  new  staudar'!  in  hosjiital  Work,  C()nstructi)n, 
manaijenient,  anil  nur.sini,'.  The  .Motherhouse 
did  not  look  u]>on  its  patients  as  1  .'Ses  onh',  Imt 
as  human  inili\'iihials,  eaeli  one  necdin.u"  kindness 
and  consolation  as  well  as  scimtilic  treatment. 
Their  wards,  thouj^h  ]>lain,  were  homelike  and 
chrerful.  and  as  ihe  Sish  rs  were  called  into  the 
.Ureat  cit\"  Ik  ispitals  they  intro/meed  tlu  rt'  the  same 
aiinosphere,  and  effected  that  moral  reno\-ation 
which  has  so  strikinj,'ly  accompaTiied  the  entrance 
into  hosjiitalsof women  of  charaett  r  armeil  with  au- 
thor it  \-,  where  wr  tliey  ha\  I'  ,L;on.e,and  whirl  1, though 
often  o\'erlookfd,  aas  pi  rhaps  hfeti  a  i  c  mtri!  )ution 
of  even  greater  value  than  their  more  obvious, 
technical  achievements  as  handmaidens  of  science. 

An  excellent  exposition  of  the  generally  accepted 
lund.iiiu  ntal  i)rin(.-ipKs  in  the  training  of  deacon- 
esses is  given  by  Schafer. '       Pret  ininent  was  the 

•  PUf  WeiblUlie  Diakonic,  \ol.  3.  The  whole  volume  is 
given  to  this  subject. 


Kai^crswcrtli  ami  tlic  Deaconess 


;| 


iJ.i'u  ihat  tlu'  liracoiKss  was  not  to  be  a  narrow 
spei'ialist  in  any  one  line,  Iml  was  to  ha\-c  an  all- 
round  ]>rc'i)aration.  While  her  talents  ami  in- 
clinations were  consulted  in  jilaein.u  her  in  p'  isitions 
uftcT  her  traininij;,  yet  she  was  not  to  be  onl\-  a 
nurse,  or  only  a  teacher,  or  only  a  parish  worker, 
I)ut  ready  to  do  anythini]:.  Xo  form  of  human 
need  in  which  a  won.ian's  stren.^'th  couM  be  exerted 
was  to  be  excludeil  from  her  pro\"inee.  Her 
rcli^nous  duty  was  foremost:  "The  most  precious 
duty  of  the  deaconess  is  to  lead  the  nn,t;o(ily  into 
the  church,"  and  ever\'  deaconess,  no  matter  what 
her  work,  mu^  .uive  tt'Stimony  of  lirr  laith.  She 
was  not,  howe\er,  to  ])roselytise  those  of  other 
reliijious  beliefs.  All  her  work  should  be  done 
in  the  name  of  the  Lord.  Theret(ire  she  neeikd 
the  continual  j^uidance  ot  {\\c  ])aNtnr,  an>1  the 
latter  must  not  onh'  wA  ignore  \uv  but  must 
oversee  and  i;uide  lu  r.  And  not  akine  the  dea- 
coness in  district  mu'sini;  or  parish  \isitini:,  but 
he  must  o\'ersee  e\'ery  deaconess  in  1;:;:  entire 
field  of  kibour,  whether  in  hosjjitals  or  other  in- 
stitutions, lujuallv  the  training  school  can  ha\'e 
no  objection  when  the  pastur  inakes  it  Ins  busniess 
to  concern  himself  with  deaconesses  who  are  doini; 
private  duty  in  \vell-to-di>  lamilies. 

While  the  pastors  diil  nut  u]jhol(l  celibacy  as  a 
tenet,  they  urj^jed  the  deaconess  to  make  her  callinj,' 
a  life-work,  and  boldlv  taught  that  marriage  was 
'i"t  the  only  nor  even  tlie  noblest  sphere  of  woman. 
and  that,  as  there  were  always  more  women  than 


40 


A  1  listorx  of  Nursim 


11. ni,  Ciod  ciiiild  not.  h;i\'(j  intended  marriaj^^-  as 
their  unly  iinrtion.  Tlie  ileaconcss,  as  has  been 
Tuentimied,  after  fi\-e  \'ears  (if  serxdee  was  free  to 
marry  or  to  return  to  lu'r  faniilw  and  she  retained 
the  control  ot  an_\'  ])ro|)ertv  of  whieh  she  mii,^ht  he 
posscsse(h 

It  is  interest  in.u  to  see  liow  niueh  of  their  s\'s- 
tem  and  detail  our  modern  traininji;  schools  haw 
inherited  from  the  Motlurhouse  the  prohation- 
ary  system,  and  the  school  for  preparatory  train- 
in'^:  the  letters  from  clerL,fyman  and  ]dn-sieian 
as  to  character  and  health;  the  allowance  of 
pocket-money;  the  L,Tadin,ii  of  work,  from  easv  to 
(liffieult;  the  chain  of  responsiliility ;  the  i^radini,' 
of  ])u])ils  frinn  probationer  t'-  head  nurse,  with  tin' 
superintendent  at  the  head;  the  class-work  and 
lectures;  ;uid  e\-iry  ])rineiple  of  discipline,  eti- 
quette, arid  ethics.  The  combination  of  a  si'ini- 
military  !orm  of  prot't'ssiimal  disci])linc  with  social 
efjuality,  tound  in  tlu  .MMihcrhoust',  ^a.\'e  the 
pattern  to  the  cirly  Anuriean  schools  e\en  more 
than  did  the  lir.^t  liln^lish  schools,  whose  s\  stem 
of  class  distinctions  w;is  w"  ,r  established  in 
Ameri(-a.  I-'r^m  tlu>  first  tlu-  ])robationer  was 
l.ikeii  into  tlie  li' lusewifely  fleparttr.ents  under 
the  eye  of  a  head  sister  (Probe  Schwester). 

Kaiserswerth  established  a  jireparatory  school 
for  its  probationers  in  1805.  This  was  to  supply 
deficiencies  in  family  traininj^  or  in  education, 
but  chictly  to  de\-elop  their  characters,  and  pre- 
vent  them  from  being  "institutionalised"  at   an 


Kaiscrswcrth  :incl  the  Deaconess     41 

oaiiy  age.  Pupils  wore  taken  into  the  ])rei);ir;i- 
torv  sehool  between  the  fourteenth  and  ei.i^^hteeiith 
vears.  Other  .Motherhouscs  fohowed  tliis  t'x- 
;imple.  The  time  spent  in  prrparatory  wi  nk 
varied  in  accordance  with  the  character,  education, 
and  age  of  the  pu]^!,  from  three  months  to  a 
year  or  more.  At  eighteen  the_\-  were  a(imitted 
as  probationers.  Continuous  and  systematic  in- 
^' ruction  was  regarded  as  indisj>ensable.  There 
'.'.■:is  a  diiterenee  ol  (ipinidU  as  to  the  rougher  ])arts 
(ii  the  housework,  scMne  pastors  holhng  that  once 
k-arned  it  should  not  be  continuously  performed 
bv  the  deaconesses,  Imt  that  hired  maids  should 
•i.e  their  strength  for  more  responsible  work; 
jiractically,  for  want  of  means,  this  \\a.s  almost 
never  rlonc,  and  all  washing,  ironing,  and  hea\\- 
housework  was  usually  shared  Viv  the  Sisters. 
(This  question  of  housework  with  nm-siiig  lias 
■en  ot  ne\'er-ceasing  interi'St  to  pastors  who 
write  on  training,  and  one  \  ery  sueeessful  or- 
ganiser, Dr.  Zinimer,  gi\as  his  expi  ru'iiee  as  in 
"avour  ol  h.i\iiig  no  maids  or  cleaners  ,tt  all,  as  hi- 
'hinks  the  change  trom  nursing  to  housework 
iiealthful,  refreshing,  and  good  for  the  nurses, 
^nd  gives  them  an  o]»portunitv  to  de\e1op  all  their 
encrg)'.)  For  training  it  was  luld  that  a  not  too 
large  hospital  was  best,  and  great  stress  was  laid 
'  -n  the  necessity  of  having  n  spacious  garden  where 
lie  Sisters  could  walk  and  rest.  Cheerfulness 
as  regarded  as  an  essential  c-haracteristic  of  the 
pujiil.      Gloomy    and     ilesponddU     temperamt'iits 


i 


42 


A  History  of  Xursin<j- 


(it  was  lu'Mi  wcu'  unfit  for  thr  work,  and  selfish- 
ness made  a  life  Ined  in  eoinnion  iinpossilile.      The 
M'ltherhousi^    was    re.i^arded    as   a   family    home; 
the  pastnr  and   the  Ol  >crin   (huly   superintendent  j 
corresi)ondcd  to  the  lather  and  mother,  and  the 
deaconesses  to  the  children.     Excessive  intimacies 
l)etween  deaconesses  were  considere(l  hannful  to 
eliaraeter,    and    Were  re,s:ardeii   with    fixed    disa])- 
pro\al,  such  pu])ils  Inin.t:  systi^matically  separated. 
Thr    imi)ortance   of  the   head    Sister's  office  was 
Well    reeo;-:nised.      It    was    important    that    hea<i 
nurses  should  teach  and  nf)t  onl\-  do  things  well 
themselves;  in;ismuch  as  it  requires  m(jre  char- 
acter t(i  be  able  to  get  good   wnrk   iVom  others 
than  to  do  e\-er\-lhing  otu  "s  sell".     A  good  Sister 
would    always    instruct    tln'    younger    ones.     The 
rules  fixing  the  nlationship  of  the  deaconess  to 
the  physii  ian  wen    strict.     She  must  be  his  as- 
sistant, not  presmning  herself  to  act  as  a  j^hvsician 
1-ut   she  might   act   indcjiendently  of  him   in   an 
emergency.      "In  all   whicli  concerns  the  care  of 
the  patient  she  is  bound  to  obedience  toward  the 
doctor  and  to  faithful  loyalty.     She  must  bewan> 
ot    anv    selt'-asscrtion    or    indej)endence.      If    the 
doctor's  ordi'rs  are  mistaken  or  harmful  \hc  Sister 
does  not  bear  th.e  responsibility."      Hut,  wliat  is 
interesting,    ethical   ditTiculties   are   provided    for: 
"  Experiencetl   nurses  have   the  right  to   remon- 
strate (luietly  and  tactfully  with  physicians,  but 
not    directly    to   oppose   them."     The    physician 
on  his  part  was  to  regard  the  hospiital  as  a  place  for 


K.ii-crswcrlh  and  the  Deaconess 


43 


teaching  the  Sisters.     He  must  not  only  treat  the 
patients,  but  remember  that  the  trainin^,^  of  the 
deaconess    makes    it     essential    that    she'   should 
\vork  in  turn  in  all  the  different  departments  of 
the   hospital.        wShafer    makes    it    clear  that  the 
i'liysician  has  nothin^i,^  to  do  with  the  management 
of  the  Sisters.     Their   discipline,    the   distribution 
of  work,  and  changin^^  the  pui)ils  from  one  war.] 
tM  another  is  the  business  of   the  matron.     As  to 
the  managers,  it  was  held  most  imjjortant  that  they 
should  never  interfere  in  the  internal  man.i-enu'nt 
of  affairs.     These  must  be  conducted  entirely  by 
the  matron  and  the  pastor.     Tlie  nuuia.i^^irs  should 
choose    these    two    ofnccrs  with    ^'-eat    care,  an,l 
then  leave  theni  unham[)ered.     As  to  the  institu- 
tions connected  with  the  Motlurhouse    (and    this 
is  also  i|uite  strikinjr),   the  accei)ted  view  was  not 
that  the  .Motherhonse  was   there   for   the  sake  of 
the  institutions,  but  that  the  latter  were  there  for 
Ihesakeof  the  Moi herhouse,  to    i)ro\ide    suitable 
places  to  teach    the  Sisters.      The  dailv  schedule 
of  work  was  about  as    follows:  The  .leacnesses 
rose   at   5,  and  went    to    the  wards,   where   they 
worked  until   O.15   or  6., ^o.  whc-n  the  patients  h.id 
their  breakfast:  they  then  had  Hfteen  minute's  for 
their  cofTee,  followed  by   j.rayers   for   twenty-five 
minutes.      The    phvsii  ians'    rounds    were    at    8. 
At    (;   there    was    a  second  breakl'ast    tor  the  pa- 
tients and  nurses,  then  ward-work  and  opirations 
until  lunch  or  dinner  at    ijori2.;;o.     There  was 
then  a  resting  time  (it    they  -ould   take   it).p.art 


44 


A  I  Ii>t()r\'  of  Nursiiv, 


)l"   which  Av.;"-   the   (juiiL    lial 


ur  spent  in 


Ih 


iKlpCl 


(jni    2    ti 


K'rt'   AW'IV 


ic'SS(jns 


and  sUii-lv,  uu'ii  ward-Avoi 


k 


tl 


Ljain,  rchirious  teach- 


in;^  1)V  the  juisloi"  at  7,  and  ward-work  until  (j, 
llien  pravers  and  ]>eil.  The  gcniTal  cuistoni  for 
niL;lit  (hity  was  for  the  day  nvu.^es  to  ihxide 
the  niL,dit  serxdce  in  turn.  Thus  of  two  da\- 
nurses  one  sta\ed  on  until  -ahdni^ht  and  the  sec- 
ond eanie  for  the  rest  of  the  time.  With  th.is  i)lan 
the  turn  came  around  to  eat'h  one  ahout  <jnee  a 
wtek;  hut,  thou^fh  there  was  iv  it  any  or  hut 
little  t'Xtra  rest  in  the  day,  the  work  was  not 
thout^ht  hard  enouij;h  to  he  prejudieial  to  health. 
Some   Molherhouses  had  a  re'Uilar  staff  of  niuht 


nurses,    who   (hd   one    n 


ionth' 


lutv  at   a   tmi 


Th 


en-  was  alwa'.'s 


nit/ht  Sister  in  eh; 


iree. 


On 


pri\ate  dut\-  the  Motherhouse  retjuestetl  that 
deaeonesses  should  haN'e  their  meals  served  to 
thein  alone  if  tlK'V  did  noi  <j;(j  to  the  family  table. 


Th 


ev  Were 


not  to  eat  m  the 


kit 


(  hen. 


Th 


ev  were 


to  ha\'e  at  least  four  or  fi\e  hours  uninterrupted 
sleep  and  an  hor.r  in  the  fresh  air  daily.  Dea- 
conesses who  Were  nursin-,^  men  must  have  an 
ord.erh'  or  niale  assistant. 


District   work   w.is   r( 
il 


an 


led   as   the   H 


owcr  of 


nursniL 


ic  cardnial  \n-tue  oi  a  district  nurse 


Was  "jiractieal  wisdom"  to  grasp  and  comj)re- 
hend:  to  sympathise,  to  rei-^ulate  anil  order,  to 
discriminate'  hetwecn  llu'  tr\ie  and  talse,  to  jiene- 
trate  t(j  causes;  to  plan  for  reij;eneration.  Slie 
must    haw    intellectual   inol>ilii\-,   comliined    >.villi 


Kaiscr.swcrth  and  the  Deaconess     45 


quiet  jicrsistcnce  aiu]  c  iUftivc-nt'Ss.  Slow  Sisters 
who  arc  uwvv  thr<>u,L:li  witli  their  work  arc  iioL 
good   for  (Hstrict  nursin<,^ 

Lcavinf:;  aside  all  local  anrl  transitory  features 
it  cannot  hut  be  recoijnized  that  the  early  Mother- 
houses,  followint:;  the  lead  of  Kaiserswerth,  laid 
down  every  fundanieiiial  ]irineiplc  of  2;oo(]  train- 
ing. Many  pastors  wrote  with  .ureat  ,<,'ood  sense 
on  methods  and  prinei})les,  h;ivin,u;  learned  them 
from  Friederike  and  Caroline  Fliedntr.  It  is 
noticeable  that  the  ])astors,  far  more  than  the 
physicians  of  that  time,  acquiesced  in  tludarire  and 
rcsponsihU'  jiosi'ion  to  be  held  liy  the  woman  liead 
and  the  share  of  authorit\-  to  be  .uiN'en  her.  Xot 
the  least  ot  the  scrvici'S  re  ndered  to  <^^ood  nursini,^ 
by  the  Mother  houses  was  the  restoration  of  the 
woman  sui^erinteiident  or  matron,  who  had  been 
eliminated  by  the  tnana^'ement  of  ci\-il  hospitals 
in  their  system  of  ser\-ant-nurses  undt  r  masculine 
officials.  The  extinction  (if  the  matron,  still 
strikingly  noticeable  in  the  great  hos])itals  of 
Germany.  France,  and  Austria,  made  a  wdldial- 
anced  training  and  discipline  impossible  in  ci\il 
hospitals;  the  control  of  the  nurses,  scatttrcd 
among  various  male  ofiicials,  waslo.st;  high  stand- 
ards were  not  thought  of,  teaching  disappeared, 
Movcnliness  v  is  the  ruU\  immorality  was  fre- 
'jiient,  anrl  the  ]i;iticnts  were  the  sufTercrs. 

The  value  ot"  the  matron  as  a  key -stone  w.as 
rdiown  in  every  fresh  work  of  the  Motherhousi'. 
and  even  more  prominently  b\-  the  reform  of  the 


46 


A  I  listory  of  XursiiiL;- 


r-n,L;lisii  hnsjiitiils  un(]ir  Miss  ^'i,l,'lltin,i^^■lU■.  The 
results  staiiii  in  stnkin,i_j  (.iiiUrasl  with  ihc  dv- 
]i!i)ra!']c  contlitioiis  exist  iii;^'  in  such  lidspitals  as 
thf  C'liaritr,    tiir   X'icnna  (uiic-ral,   aiiil    llie  s/ix^at. 


r 


ins 


hospitals    iiiniic'iliaU'l\-    al'li-r    laicisalion. 


It  must  also  ]'v  notrd  that,  as  a  result  of  ac- 
cc'ptiii_L,^  tlic  authorit}-  of  the  matron,  the  Cicrman 
])astors  v.'trc  far  in  aih-anec  of  the  (urman  l>h_\'- 
sicians  ot  that  time  in  the  reeo_L,Miition  of  Miss 
Ni^L^^htintjale's  services  for  the  elewition  of  nursing. 
Her  lHX)ks  were  translateil  into  (urman,  aiv,!  her 
leaehini^fs  an-  frei'h"  (|uoteii  l)y  Sehat'er  aii'l  others. 

We  do  not  attempt  to  foil  nv  the  ,L;Teat  extension 
and  duplication  of  the  deaconess  Mcjtherhouses 
thrf<a,i;h  th  sixt\'  >'ears  followini^  the  foundation 
of  KaistTswerth,  as  there  are  many  excellerit 
ref. '-ence  looks  a\-ailal)le  which  iri\-e  careful  de- 
tails ot  tlK' numerous  fields  of  AX'ork  and  institu- 
tions both  al'lil'.ated  with  and  indei>endcnt  of  it.' 

That  teatvu'e  ot  the  sulise(|uent  di'Xelojinient 
of  the  female  diaeoni'te  uhic-h  belonL^^  to  our 
subject  is  its  relation  to  nursinij;.  As  time  went 
on  and  eomju'titioi,  entered  undeniably  into  the 
fiel<l  ot  the  deaconess  work,  much  of  the  earl\- 
zeal  an',  '.eshness  wore  otT  and  a  greater  n.gidity 
entered  into  the  life.  The  econoniic  proliU-ni  was 
ever  present,  and  tln^  maintt'iiance  of  this  large 
body  of  workers  had  necessarily  to  be  of  the  sjKirs- 
est  characti'r.  The  immediate  control  of  dio- 
niestic  and  nursing  details  fell  more  and  more 
1  i^ci'  A]ipcndi:\  for  bibli'igrajihy. 


Kaiserswcrth  aiul  the  Deaconess     47 


I'nnt  accidentally)  intf)  the  ban. Is  of  the  jjastors, 
•'.ho  believed  lIn'V  had  learned  eiiout^'h  to  lie  able 
hucccssfulh-  to  niana.t^^e  this  ]>art  of  the  system. 
Women  were  taken  on  youni^er  and  vounc,'-er,  and 
overwork  of  a  se\-ere  and  often  eruel  character 
became  common. 

Tlie  necessity  of  earning:  mf)nev  bv  sendin.c;  the 
nurses  ont  to  hospital  ser\-iee  often  (|uite  ])Ut  an 
end   to  careful   trainin.i;.      Women    of   a   superior 
ai)ilit\-  were  less  and  less  attraeled  t(^  the  callini,' 
and  the  ranks  remained   lari^ely    lllled    from   the 
peasant  class.     The  oeeasional  de\-outly  '"■■lii^dous 
aristocrat  who  entered    a   .Motherhouse,  aad  who 
thereby  received    much  adulation  from  the  })ens 
of  chroniclers,  invariably  entered  upon  the  jnisi- 
tion  of  suptrinti-ndent,   for  wdiieh  she  had  often 
fitted    hersel:     ])ut    superfieialh-.  bv    a    ])ractical 
apprenticeship  of  a  much  briefer  sort    than  that 
pone  through  by  the  avera.i^v  Sister.     Thus  little 
by  little  the  practical  abilitv  of  the  women  he. ids 
to  teach  the  probationers  tell  bc-]o\v  par,  and  the 
numerous  memliers  of  tiie  medical  ]>rol\ssion  who 
were  not  in  symjiathy  with  the  deaconess  move- 
ment   were    able   to    claim    with    truth    lliat    the 
matrons    were    not  competent    to    teaeh    nursini;, 
and    thus    jiress    a    disposition    to    dispt'use    with 
them  entirely.     The  increasinL^  j'rominenee  of  the 
l>:tstors  was  also  most  obnoxious  tonie(]i(-;  1  nien. 
Physicians  declared  their  hostilitv  to  then-,  on  the 
.l^Tounds   that    tluy    inttrl'ered    with   tb;e   eoinpirte 
subordination    of    the    nurst-   to     the    iihysician; 


48 


A  History  (^f  Xurhing 


that  th<v  t'lM  thr  deacnncsses  tluTc  were  certain 


ir.edie; 


( )ri  1 


■rs  that  could  iidl  be  <)lie\- 


suci 


as 


tellini 


palieuts    un 


truths   al'iiut   their   eoncHtion, 


hou 


t    the 


aletv  (il    I  >!)eral!<  )n,  ete 


])astors 


\v 


ere  also  ('] )] )i  iSi.  1 1  to  the  us(_' ( )i  narcotus.  Certain 
physicians  exjjressed  themselves  s'rontily  in  maga- 
zine articls. 
riifht    or    reason    in    nur;-i!i^    af.iu-s. 


md   said   that   the   ])astors   had   n' 


and 


.th 


(i> 


declared  as  em])hatica]ly  that  it  was  absuril  to  ,ui\ c 
the  <  '1  H  rin  (matron)  anv])laeein  a  nursin.^  system.' 
Boih  pastors  and  a  certain  proportion  of  phy- 
sicians were  etjually  averse  to  dealing;  with  women 
of  force  ;.'nd  ori.uinal  ability  and  both  eciuallv 
dreaded  the  well-eilucated  woman.  Freedom  of 
thought  bceanu'  ..  thin;^  dt'iinitily  forbidden  in 
tile  Moth,  rhouses,  as  is  illustrated  by  the  i)ersonal 


testnnonv  to  tlu 


ivnii. 


of  h; 
Schiller. 


,nter'-  oy  aone-lnne  deaeones' 

■ks 


been   h.-rbidden   to  read    the  works 
"iiis  rejircssion    oi    the   inlellettual   lite 


is  also  ani])ly  attested  by  innuiner.Lblr  eUrieal  writ- 
injjs,'^  and  acirtain  aversion  to  .i  hii:li  educational 
sttindard  is  eciually  clearly  atti'Sted  in  writinj^'s 
of  jihvsieians,'  though  these  were  jKrhaps  not 
in  the  niaiorilv. 


1  S>'i'  /'.'(r.^orfii'  (j!(/  drnt  Gcbictc  drr  Kraukciiwartung,  in 
ll^indliiiih  dir  Kranki  luvrsort^mig  tiiui  I\ravlceni';li-gf,  Liofx.-. 
Jacobsohn,  and  Mcyi-r,  vol.  ii.,  part  i.,  p.    174. 

J  Si'c  liiblioj'niiJhii'S  in  Scliafcr.  Die  W'libliclie  Dtakomc, 
an<l  in  Lidn-,  jai'<)l)Sohn,  a*id  MoyiT. 

J  Fursiyrt;c  atif  dcin  (ii-hiiU'  </i  v  Kraiikrupflvge-l'titerrkhls, 
See  Lit'ln',  Ja.  <ilisi)lin,  and  Mcvcr  ciji.  nt,  vol  li.,  j)art  i  . 
pp.    >74-3»« 


M 


K.ii>crs\verth  and  llic  Deaconess     49 

Strangely  cliaraftirislic  of  those  who  ajiplv 
rt-iirc'ssion,  thc\'  Net  teU  (hssatistied  with  their 
liwn  results  .'md  seriously  disiusstij  them  without 
perceivini^f  iheir  eaus.il  relations.  W'ry  signifi- 
cant are  the  titles  of  ])a])ers  read  by  the  ]iastors 
nf  deaconess  institutes  in  later  years,  sueh  as; 

Why  do  so  few  I'asti.rs'  Daughters  dcvo'.e  thcin- 
-  ivos  to  the  Calling  <>f  the  Dcaeoness? 

How  shall  wu  gain  more  Sisters  for  the  Deaconess 
Calling? 

Means  of  Increasing  the  Numbers  of  Deaconesses 
and  of  Overcoming  Prejudice  against  the  Office. 

What  is  done  and  What  can  be  dune  t')  Preserve 
the  Sisters'  Physical  Stmv.rth? 

How  are  the  Deaconesses  i"  he  !\(  jit  in  the  right 
frame  of  Joy  in  their  Work  and  Ouardtd  fpiin  Ajjathy 
and  Dulness? 

Of  certain  Present  <>t  T  eatening  Detei  ts  of  the 
Deaconess  Institutions. 

How  shall  tlie  Sisters  Pmtctt  Tln'inselves  from  the 
Dangers  of  the  Mori)linie   llalutr' 

What  Dani^'crs  to  the  Deaconess'  Callin;:  arc  inci- 
•lental   to  Institutinn    Life   and    !h>w   shall    ue    .Meet 

What  is  Xeccssary  ^n  the  j^art  nf  t!u  Dir.etors  to 
Preserve  the  Health  of  the  Sisters  and  Ouard  them 
a^'ainst  Premature  Invalidism.' 

The  narrowness  and  arl)itrar\  limitations  intro- 
diKe<i  iiltle  by  little  into  the  deaconess'  life  could 
'"'t  fail  to  strike  vigorous  and  reasondoxing  minds 

"^  'i.'lfer, ''/>.  fjV.,  Vol  i,  A      :>rk-ungni.  ]  ]>    .^i5-.uo. 


50 


A  History  of  Nursing 


unplrasantlv.  .'in.l  the  whole  inner  atmosphere  and 
tLT   of   the   ninre   rerent   trainini,'   and    dis- 


etiarai 
c'iphtie 


remar 


h; 


i\"e   lirt 


■n  sc 


t   \(    ih  in  till'  ]'a;j;es  of  a  very 


kaMe  luxik,'  whicn,  in  the  i'>ru\  ot  a  smi] 


narratiw  franieil  on  nothint;  more  exeitm^^ 


th, 


111 


tile  story  of  an  a\(ra;4e  i,'r('up  of  ])ersons,   i;n  "^ 
a  ]iieture 


t  lie  (Ifaeoness 


liani 


life  drawn  hy  a  master 
il  wilh  as  1  meh  d.rpth  "f  human  feelinij; 

(lahriele,  the  daueh- 


as  of  inielleetual  pi'ree])tioii. 


ter  o 


a  wc 


11-t 


o-do  laniih".  and  \\ho  "\Nas  ciidoWi'd 


ruhh'   with  iiualiiirs  of  head  and  ot   heart,  went, 

1  \a't  insistent  wish 


1.  .11 


ow'.ni:  a  sane  and  halanee' 


1o   'M\ ' 


to  a  deaconess  li'  lus 


V  and   eiUerei 


upon    llif    trainiiii^.      SI 
arlulrarilv  demanded  o 


\v 


1()und    that    what    was 
)f  hiT,  alx  >\  e  atidi  Icvond  the 
if    nursini:;    to    sell  saeritiee,   was 
nothing  less  th;iii  the  negation  of  her  whole  per- 

th 


natural    (.lainis    i 


sonah 


t\-,  the  sai  rifiee  of  her  natural  ri'lations  wi 


the  outrr  woi'ld.  the  renunciation  ot    nimtal  recre- 
ation  and   of   ;ill   hi'^licr  education;   in   short,   the 


atn loliN'  c it  lur  iii' n\idu. 


■If. 


All    llie   mintiti 


>l   details   ot 


tht 


(lailv    lite   an' 


.ketchrd  in   with  a  dilu  ate  touch  alio  syn;]iath\ 
tiid  thr  round  of  the  d,i\s  in  traininj;  home  an. 


hosp 


ital 


war  1 1 


lotlK  ! 


onl\-    iia' 


licen    ijescnhi'il 


by    fme    whi 

sket 


n\  (0 


aractiT 


clU'S  ai'c  \  i\  1' 


dravn  troin 


1  and  sjiiakinj,;;  i-aeh  one  seems 
The  matron,  of  Imuntcoiis 


ll!c 


motlurlv  j;ouduess.  l<ut  a  little  removed  from  th 


>  /•• 


Di.ii'it,  hv  I.ni<.r   .Mi;nsl,rdt    (L.    Annshaj;tnl 


ICrnest    Hi.. It,   l.<  ip/.iR,   11)04 


Iv.iiscrswcrth  and  the  Deaconess     5' 


1 


ildsr  iiiinu'ili;itc  linu'li  witli  thr  inili\  idunl  pujiiis; 
tlu'  assistants  aii'l  Sisters;  ihf  pf 'batioiirrs,  who 
alwavs  i'"ii'il  tn  eat  twu  n>ils  in  the  short  hreaklast 
time  all'iweil  them;  the  jiastor,  eliiet  ol  all  in- 
struction j,M\'en  tile  proliationers,  who  ,ua\e  his 
nwn  clau,i;hters  e\ery  social  and  t'aniily  ])l(,isure 
in  his  p'lWer,  anl  wouM  not  ha\'e  dreameil  ot 
lettinj,'  theni  liecome  deaconesses;  the  patien.ts, 
even  the  porti'r  ;tt   the  do,  ir-  all  are  litelike. 

As  lialiritle  looked  arournl  tin-  t;iliU'  at  her  lirst 
meal,  she  saw  the  asseniMed  Sisters  looking'  very 
inaeh  alike  in  their  unilornis: 

I'eari  tul  CMiinti'iianees  a  little  sulKhuil  perhaps 
an<l  tired,  yet  a  readiness  for  jest  and  (  lieert'ulr.ess 
\v;is  there.  Faces  ui  j^ood  inlellij^'eiui',  slidwini,'  a 
little  liidilTeTeiiec  to  the  impressinn  made  h)-  llieiii 
uthers,  perhaps  a  little  iiiililTereiu  e  in  -I'lieral 
t'Wards  all  persons  who  were  n^t  si<  k.  Or  was  this 
"iilv  al)Sor])ti<>ii  in  v;(.rk,  and  m-erstrain,  wlii'd-;  was 
in<ire  evident  as  they  sat  d'^wn'  MiKt  <>t  tlieni  wef 
]>ale  and  lookt  1  as  it  Ih.ey  neiMle.i  air,  while  ethers 
were  fresh  and  pretty,  not  unheconnn^dy  dad  in  the 
ilnseea]).  (.'lose,  smooth,  scanty  hair  eomhed  d^wn 
fn'ni  hroad  ])artin^s — the  continuous  nibbing  ^vuh 
the  cap  border  wure  it  so  — ' 

Ihnv  did  most  ot'  the  aiipli'  iiils  eonie  ? 


The  Margaret  School  was  tlie  ]ire])aratnrv  insti- 
tution for  the  Motherhousc.  I-'nurtcen  ^ear  'M  jjirls 
eanie  to  it  from  the  common  schools  and  were 
•'"'"  'luring  four  years    prepared  for  tiie    deaconess 


('/•.   at  .   p.    7 J. 


A  Hi.>tor\  of  XursiniT 


callinp;.  The  n-orld  aiiil  Innnankind  and  the  f^rcat 
(Ivnamic  forces  outside  wore  unkn^Avn  ti  them,  and 
there  was  for  them  no  sacrifice  of  social  ties.  In- 
stead, for  most  f)f  them  tlieir  importance  in  the  social 
scale  rose  when  tlu  y  donned  the  deaconess  dress. 
The  Sisteis'  cap  w:is  their  j^'oal  thnjugh  all  their 
younj;  years,  and  when  they  received  it  they  were 
so  delighted  that  they  woiild  not  have  understood 
a  suu:,<,'estion  that  they  had  anytliini,'  more  to  wish 
i<ir.  Good,  earnest,  idiecrful  maidens  were  they, 
fall  oi  Inyah  V  and  zeal  for  their  wi>rk,  full  of  reverence 
fir  the  hmi^i'.  .Scarcely  one  ><(  them  would,  in  the 
v,-orld,  ha\e  been  called  an  educ.Ued  youn^'  Woman.' 

Gabriclr  had  at  the  outset  attrilniteil  the  scanty 
])in-nii)iu'\-  to  the  necessity  for  economy,  and,  her- 
self linanciallv  inde])endent ,  had  never  fuced  the 
economic  i|uesiion,  mHil  it  was  bnni^lit  to  her 
one  da\-  hy  hearini;  the-  teaclnn.L;  Sister  s]ieak 
hclittlin.y;!}'  of  those  who  nursed  fur  their  lixiuL;. 
"(  >ur  Slaters,"  said  she,  "work  soleh-  for  the  low 
of  Cdiri^t  — not  fur  a  salary." 

Ciahriele  thou.uht  a  mi  iinent  : 

Does  money  make  a  ditferencc  '  [said  she]  Dn  you 
mean  that  the  love  of  mankind  and  a  salary  arc 
irrocoiu-'lable?  .  .  .  Can  money  jjrevcnt  one  from 
workiiM  in  a  s]iiril  of  love?  Teachers,  physicians, 
pastors,  all  take  money— and  no  one  rcroaches  them 
for  it.  Even  without  the  payment  of  money  one 
might  still  work  without  love.  .  .  .  ^ 

'0/..ci7.p.  77. 

'<)/>.  cit.,  J).  0?-  ^'1  this  poirt  Miss  NiRhtingalc  said:  "It 
apiKiirs  to  be  the  inosi  futile  of  all  distinctions  i<>  classify  as 


!N.ai>crs\vcrth  c'lnd  the  Dcdconc^s 


:)j 


3 


The  jtaslor's  classes  wctc  paiiiiiil  occasions, 
•or  the  ])aslor  <liil  not  know  liow  to  teath,  aivl 
r)nly  succeeded  in  iiilimidalinLi  his  ahx'ad}'  shv 
and  unready  i)u]m1s.  At  liis  (|ucstions  the  pro- 
hationers  slmmk  into  ilunisehcs  and  apjieared 
even  more  mediocre  tlian  they  r(.all_\'  were.  Then 
so  wearied  were  they  always  that,  in  spite  of 
themsehes.  their  eyes  closed  in  slee|i  and  their 
heads  fell  \\hent'\-er  the  attention  ol'  the  tiaehtr 
was  turned  from  them  for  a  nionient,  until  a 
sarcastic  exclamation  u.ikencd  them,  t'mbarrassed 
and  Self-conscious.  (lal)riele  was  toneerned  and 
depressed  by  thesi   halt  hours. 

Couhl  the  paster  l)elie\e  in  iiiakinj;  tla'in  humble 
through  humiHatiDns"'  the  pi  Mir  thinirs  were  already, 
with  their  work,  their  siek,  and  their  discipline, 
eiintinuously  e.Kcreised  in  lunnility, — did- they  need 
erushinj,'  to  learn  to  place  all  their  hope  in  (h\ine 
mercy?  Could  it  l)e  possible  tliat  v/hat  ^\as  aimed 
at  was  the  destruction  of  individuahty.  instead 
I  if  the   sanctirtcation    and    development    of    the   in- 


lutwci'ii  'paid'  and  'unpaid'  art;  so  between  paid  and  un- 
paid nursing — to  make  into  a  testa  circumstance  as  adventi- 
tious as  whether  the  hair  is  black  or  brown,  vie,  whether 
IKople  have  private  means  or  not.  whether  they  are  obbged 
or  not  to  work  at  their  art  or  their  nursing  for  a  hvehhood. 
I'njhably  no  jierson  ever  did  that  well  which  he  did  only  for 
money;  certainly  no  person  ever  did  that  well  which  he  did 
not  work  at  as  harcl  as  if  ho  tlid  it  solely  for  moncv.  If  by 
a:nateurs  in  art  or  nursing  are  meant  those  who  take  it  u]) 
If  play,  it  is  not  art  at  all,  it  is  nut  nursing  at  all.  You  never 
:  ni.i.le  nn  artist  V>y  paying  him  well;  but  an  artist  ought 
i>c  well  paid." — Introd.  to  Lifr  of  Agues  Joins. 


54 


A  Ilistorv  of  XursinQf 


(li '-'i'lual    f')r   tlic   serx'iie   of   CimiI   by  ex'cry   <.;ift    an  1 
furcc  and  by  ihf  use  nf  all   the  means  of  he!])  an  i 


cu 


llure  thru   aiiouml  in  the  w  .rid: 


SI 


le  Was  terniu'' 


ii    the  1  MiMiu'ss  I  il    Iter   own 


ihoui^iUs.  \\\  the  "wiMuanlx'  simplicitv "  on 
which  jiastoi-  Lojic  liai]  written  a  whole  luxik 
seeineil  lo  her  like  nothing;  hut — stnpiJity. 

I'iiialK'  came  the  i]a\'  w  heii  her  relati'  ;i  witlt 
tile  Ml  itherh' itise  came  t'l  an  (nd.  Il  was  the 
li'i'ir  for  ])astor  Mck's  IhMe  (.'lass,  an^l  the  meek 
xoiuil;  '.onie'i  sat  h(  fore  hiiii.  stru'''din''' with  their 


tatigiu 


A  Innt  (>•    iron 


it.'  expression  on  tlu'  pas- 


tor's   niiM\'    countenance    t'on\e\eil    a    tliouyht. 


w 


ithout  Words,  that  made  tln'm  dimlv  con 


scious 


To-dav  li( 


ot   iKinsj;  toolish,  stnpid,  innnl<inned 

spoke     espcciallx'     ot     the     rei  luirenients     of     the 

deaeoni'ss  .  caIliI■i,l,^      "  I-.xaniine     \-ours(_'l\-es     [said 

he)  to  si-e  whether  vou   1  iriiiij;  with   xuu  a  liexihle 

sjiirit,  out  of  whieli  a  \'et  hi,L,dier  mav  he  moulded: 

si't  natures,  that  resist  moditication,  lit  ill  to  the 

Ser\'ice." 

(iahriole  wondi'red  wheth.er  ]'V  "  r:iodilit'ation  " 
lie  mean  th.'  crushini;  n\  ]ier-;onalit_\'  and  tlie 
i^rindiiiii:  in  the  wheel  of  tml,  and.  whetiier  th.it 
Was  a  means  ot  attamini,'  eomjdete  domination. 
Of  IcaruiiiL;  he  said  that  it  dared  never  be  sou^dit 
for  its  own  s:ike,  as  it  then  iV  'irishcd  jiride:  that 
"the  -reat(,sl  h;ip]iincss  of  the  work  l:i\'  in  ohe- 


th 


dunce,'  and  he  then  dr<.w  a  picture  oi  tne  ideal 
deaconess.  She  sjiarkleil  with  the  diaiiKiiids  of 
evi'rv    iniaL,Mna!ilc    \irtue,    ineludiiu'    loftiness    vi 


KaisLTSwcrth  and  the  Deaconess 


:)D 


liiMii^ht;,  down  to  the  smallest  and  finest.  That 
was  what  cl(.'  u'diiesses  must  and  should  be;  then 
fi)Il<'Wed  wliat  thf\-  must  not  be: 

•■He  not  onI_\-  humble — no — lo\a'  humiliation, 
and  take  no  oiTenee  therefrom.  Can  vou  f|uote 
a  \-ersr,   Sister  Lisbeth  r " 

■•  For  (iol  resisteth.  the  ])roud,  and  L,M\-eth  ,l  a\ 
Im  the  humble.''  "  Wlnre  is  it  fiund'"  She 
.^ave  till-  jilaee.  If  any  one  a])i)r(  ..elu'd  to  this 
ideal,  it  was  Sister  Lisbrth,  and  vet  she  alwa\"S 
.Seemed  to  inspirt.^  a  eertain  leclinj.(  of  W'.xation  in 
the  ])astor. 

■■  Hm  it  is  also  jjossiblc  to  fall  iiUo  a  pride  of  hu- 
mility, some  have  b'jastdl  of  tlva'r  huniihty — beware 
of  liiis.  Egotism  is  sinfub  and  e\-en  the  craving  for 
enjoyment  is  so.  Xat\irally  I  speak  of  spiritual 
enjoyment,  f'>r  ynu  i.'ave  st  aratcd  \-o\irseh'cs  from 
that  i>\  the  world.  .  .  .  Friendshijis  and  family  tics 
(nnccal  danijers  also  -I  liave  warneil  you  against 
these,  and  in  this  eom-ection  I  nia>-  mention  iotter- 
writin.L,'.  Seek  not  after  no\adties  and  rMin]i!air,  not. 
.  .  .   Read  the  [)ara,L:rapii  on  pa,L,a' jS,  '()n  Dressing'." 

Sisti  r  Lisbeth  stood  up  and  read  in  re\-er(,!i- 
tial  tiMics: 


".\s  a  Christian  sanctifies  everything  tlircjugh 
prayer  and  the  word  of  ('.(nh  why  shall  not  a  deaconess 
make  dressing  alsii  a  time  of  holiness?  To  tliis  end 
I  recommend  the  following  prayers.  In  the  bath: 
'U'a'^h  me  well    from  mv  misdeeds  and  cleanse   tnc 

■a    my   sins.'      In    puttmg   nn   the   ifalung.    '  ( )ur 


D' 


A  Ili^tDiA-  of  Xursinix 


riu'litcousness  is  like  a  soiled  Lranncnt.  Hut  he  \v\\n 
e'HiqiuTS  shall  he  elutheil  in  -white  raiineiu.'  In 
tvinu  I  in  the  aja-iin:  'Wh'i  v.  ill  ^er\-e  me,  let  liiin 
fnllow  me.'  In  ])Utting  ini  the  cap:  'Tlmu.  L'^rd. 
blessost  the  ri.tihteous  .uid  efAvnest  him  vith  merey.'" 

Gcibriclc  lookcvl  ;:i  the  tliin,  ittiwnrMly  face  nf 
the  t^fey-h;iireil  iJrnbatiomT,  ami  then  at  the  iiiorn- 
iii'j;  drtss  of  tlie  pastor,  and  wondered,  doulitiii.ij:, 
whethi  f  hv  folhAMMl  a  like  pfcjj^ranuiie.  He 
coiitiniii'ii : 

"What  I  sav  n^  ^v  I  do  nut  make  a  matter  of  cen- 
seicnee, — it  is  only  my  ad.\iee.  ( )rder  is  also  whule- 
some  for  the  soul.  Once  a  day  a  dea  oncss  sh(ju!d 
hunihlv  e.Kamine  In  rself  -jTeferahly  toward  exenini:. 
Onee— better  in  the  eourse  of  the  foreniion — brini; 
God  a  thank-offerinjj;  for  His  mereies;  iinee  -]ierha]is 
about  three  o'eloek  — rcfleet  on  the  In  air  of  death. 
It  is  also  .advisable  often  to  ])r,i(iise  a  jirayerful 
e\i  reise  id"  f.aiih  and  hatred  >'i  sin.  .  .  .  Finally 
I  reeommend  satisf'in^  rcadin;^';  not  oidy  the  word  oi 
(iod,  and  not  b\"  any  nnans  the  tlo' 'd  of  (diristian 
tales  udneh  enfeeble  one  and  su;,';^'est  a  h  i\e  ot  pleasuf, 
bnl  tlu'  reading'  "f  ' 'ur  "Id  aseeties. 

"  K.Kereise  vourselves  ilaily  in  obedience,  in  liumility. 
and  in  subnassion  both  of  body  and  soul.  Our  blessed 
(atluT  LoJie  said:  '  \'ou  sliall  jTactise  an  obi'diencc 
that  shames  the  autlidritics.  \"n\-  joy  shall  be  more 
and  more  in  lo\vliness,  in  un])retcntiousness,  and  i'l 
meekness.  " 

Ml'  then,  turnedi  to  Sister  (iabriclc  and  asked 
hiT  for  an  appropriate  verse,  and  she,  o\erl'orne 
by  a  risinj;  tide  of  rcdiellion  and   dissent,  for.^et- 


w 


Kaiscrswcrth  and  the  Deaconess     57 

tiii.t::  luTSc'lf  and  all  anmnd,  arose  and  in  a 
strange  yoWv  said:  "Woe  unto  you,  Serilies  and 
I'liarisees,  hypoeritesl"  .  .  .  "For  thev  'oind 
lira\'\'  i)url(.'ns  and  <:;rievous  to  \)v  horne,  and  la\' 
tilt  m  nn  men's  shouIdtTs;  but  tlie\-  themselves  will 
net  move  them  with  one  of  tlieir  finj^iTs"';  and 
aijain  :  "W'ne  unto  you  .  .  .  for  ye  lade  men 
with  burdens  ^i^rievDus  to  be  borne,  and  ve  \'our- 
selves  toiuh  !Vit  the  burdens  with  one  oi  nnir 
finj^ers."     They  are  found  in  Matthew  and  Luke. 

It  was  like  the  breakinij;  of  a  boml),  and  pale 
horror  sat  upon  the  faces  of  the  fri.^htened  Sisters. 

Alter  this  scene  Gabriele's  furth<T  continuanet' 
in  the  sisterhood  was  naturally  not  to  be  thought 
111,  e\cn  had  she  herself  not  ea,e;erly  weleonied  tlu' 
rei:;aiiied  freedom.  Later,  in  the  jKistor's  studv, 
he  rei  mired  her  to  explain  herself. 


".\mw  yiiu  shall  tell  nie  what  ymi  meant  by  yiair 
c'xtra-niiiiar\'  W'^nls.  Literally,  they  seem  tu  mean 
that  1  I'l  ii'ii  myself  do  what  1  demand  from  nthcrsr'" 
She  noddeii.  "Hut  I  did  nut  mean  _\'ou  espoeialh', 
hut  the   prineip!.-,  " 

"Indeed.  So  yovi  sj)oke  with  intention  and  hold 
■  '  viiir  words.  .  .  .  What,  cxaetly,  did  you  tnean  bv 
:-i'eakinji    so   audaeiously    before    the   class?      Well?" 

"1  nieant  the  dt)uble  standard  by  which  you,  but 
not  you  only,  measure  yourself  and  the  Sisterhood." 

"Then  I  must  hrst  jxiint  out  to  vou,  that  the 
.'.ithority  is  derivc<l  from  (lod,  and  is  suppc^rted  by 

e  Seripturcs.  Leaders  and  doers — both  -are  nec- 
essary in  cxi'ry  sjihere  of  work;  .   .   .  where  you  have 


A  History  of  Nursing 


lalxnir  ')f  hand  (<t  fodi  I  liave  tliat  of  the  brain. 
My  rcspitnsihilitv  is  mw  !i  i^rcattT  than  yours.  My 
\vork  is  (juite  (iil'lcTcnt  thiTftnre  my  ]  rcparatKin 
and  ir.ude    d    \iiv    must     be     ditYerent.        You 

i-annot    comjiare   tlie   ium." 

"That  is  just  what  I  mean  -that  difference.  .  .  . 
\'ou  speak  unw  of  work,  l)Ut  in  eiass  you  sjieak  of 
renuneiati' in,  of  self-iUiuab  of  resi,i^nation.  We  a;-.' 
to  be  ho'i.r  than  you      the  ( leri^y.  " 

The  pastor  spran.i^f  uj)  aiiil  resented  tliis  iiide- 
pendeiil  spt'eeh,  aii'i  reiniiulcd  dabriele  of  the 
authority  of  tlte  captain  of  a  ship. 

"But  that  is  ditYerent,"  said  she,  "for  lie  has  j.  one 
throuj^di  every  staj,a'  of  the  sailor's  work.  He  know^ 
e.xaetly  wliat  he  commands.  But  you,  Pastor  I'.ck. 
have  never  liad  any  e.\j)erience  of  what  you  iri..ke 
bindin:;   on   us.   .   .   ._ 

"Vou  demand  the  very  liighcst  of  us,  even  to  our 
m<ist  secret  thou.t,dits  and  most  intimate  feelings 
an  unnatural  strenjrth- -and  at  the  same  time  you 
elose  the  source  of  this  strcn.i^'th  to  us.  Strength  is 
life.  You  demand  from  us,  in  the  same  breath,  both 
a  higlily  concentrated  life,  and  the  denial  of  life. 
You  ask  what  is  imj)ossib]e."   .   .   . 

"The  source  of  strength  is  the  holy  Gosjjel."  ,  .  . 
said  Pastor  Eck. 

"  Truly,  I  have  never  been  so  little  able  to  read  it, 
as  here.  If  it  is  true  that  'man  Ii\-es  not  bv  bread 
alone,  but  also  b\-  tlic  word,'  it  is  also  true  thai  he 
li\"es  not  by  the  Word  alone,  liut  i>y  bread  both  ari.- 
essi'ntial.  .  .  .  Oiu"  hea\'enl\'  I";ither  gives  us  many 
pleasures,  and  it  is  His  will  tliat  we  shall  ask  for  them. 


I 


Kaiscrswcrth  and  the  Deaconess     59 


Mufli  is  bcsi.Avcd  ujxni  iis  for  the-  animation  and 
elevation  of  our  fcelin,i;.s  and  our  inii  licet  fi  r  \vl' 
also  W'lrk  with  hotli  of  ihcse.  not  nnh'  with  hand 
and  loot  —lor  relreshment  and  ixcnisi-,  for  <i,ri'li- 
nicnt  and  development,  such  as  vnu  prizi^  and  know- 
how  to  use,  such  as  you  consider  vnur  inattcr-of-course 
riLdit,  even  nciessity.  The  ])lcasurcs  of  nature  of 
ilic  cultivation  of  t!:c  intellect,  noble  literature, 
i.c.ily,  friendsiiip,  and  ton.i^cnia!  society  these  are 
the  additional  sprint^^s  of  strcn.L;th  that  wc  also  need 
to  enjoy  in  in(  njcration.  Withnnt  tlii'in  our  cahnis^' 
is  a  continuous  ut-vivin.i,'  without  iri-takiiiL'  lUit 
we  must  ^d\c  tij'  all  that-  \i.ur  will  and  the  (Acr- 
work  crushes  it.  And.  instead,  dhedicnee  shall  'e 
the  hi.uhest  joy  of  our  i.lhnir,  atid  to  he  iesjnsed  a 
]tleasure.  Do  you  not  call  that  la\-in,L;-  un(  ndurahk^ 
hunlens?" 

Pastor  lu'k  st'cined  somewhat  impressed;  but 
defended  himself  by  the  ar>,nm>  t  that  iiK-.t  >>i 
tile  Sisters  did  not  feel  in  this  way;  tliat  (ia.irielc 
])ossesse(l  ;i  strong  mind,  ^^  hie'  they  had  not:  that 
the  majority  of  women  dc  .ire',  to  be  led  and  were 
not  capable  r)f  ori.i^dnal  tliinkint;  nd  doin^j;  that 
in  their  arda  tit  lo\-e  of  Llod  they  were  not  ciniseious 
of  self-saentiei — but  Gai)rtele  interrupted  him 

•'(){  being  sacniiced.  .  .  .  They  all  suffer —all  the 
Sisters"  said  sib  "  from  tlu'  mental  starvation  that  is 
directly  apportioned  to  them.  If  there  are  ])iThaj)S 
those  who  do  not,  it  is  because  their  subjection  is  com- 
])lPtc,  or— because  there  was  nothin.^  in  them  to  starve. 
'Ae  have  the  protection  of  die  sixth  commandment 
Th.ou  shalt  mit  kill.     Oli,  1  k-     w  vcrv  well  hunccr  is 


6o 


A  Ilistorv  of  NursinsT 


a  mcan-^  of  'iisiipliiie    -<i   means  of  j^'aining   inaslcry 


(A'lT  till'  niiiii! 


iiifdicinc. 


It   ih 


e  (k'ac(;iU'SS  worl 


and 


StU(lR'( 


Thr  st'irv  is  no  ima'nnarv  oiu-.  but  lakrii 


i  roni 


the  life.     The  mtelleetual  i)o\erl\-   (and  not  that 


oiilv 


f<  ir    p 


()\-ertv    luitrht    he  remedied)   and  the 


reslrietions  on  freedom  of  tlv)U''ht  in  the  deaconess' 


ea 


IHni 


:o 


hand   in  hand   with  the  economic  de- 


])en('enc\'  and  the  social  bareness  of  the  hfc 


and 


ire  out  ui  touch  witli  the  ])roj^'ress  of  the  j)resent 


ccnturv 


Th 


ose  women   who  iirst  renounced 


the 


clamis 


of    the    Motherhouses 


on 


:roi 


mds  similar  to  Ga- 


bnele's,    and    who   then  eiidea\-oured    to  make   a 
self-supporting    occupatitjn    of    their    calling    as 


nu 


rses,    had    a   hard    and    bitter   struggle 


amst 


prejudici',  but  nevertheless  the  exodus  of  the 
least  subinissi\-e  and  meek  began  and  still  con- 
tinues.    The  basis  of  all  resentnient  against  them 


was 
ani' 


that 


womtii  who  had  for  centuries  worke( 


slaved 


tor 


b; 


ire 


li\elihood  should  now  cease 


to  be  satisfied  with  so  doing.  Not  easily  would 
charitalile  institutions  and  the  Church  gi\e  up 
their  unpaid  workers,  and  th 
right  to  the  earnings  ol 


e    assertion    ol 


one's  labour  was  character- 
ised as  godless,  sordid,  and  debasing. 

As  the  deacones;,    organisation  was  in  its  first 
di'\-eloj)ment  a  gri'at  steji  forward,  it  has  pro\ed 


r 


I  ( '/'.  ill.,  ])p.  274  2S0. 


K.iiscrswcrth  and  the  Deaconess     6j 

to  In'  not  the  final,  I'ut  ouv  of  a  number  of  steps 
(if  ](hases  of  soeial  and  ot  nursin,!:^  proj^Tess.  It 
is  >tiil  aeti\e  and  stroni^,  holds  a  definite  and  ini- 
piirtant  plaee  in  ehureh  and  mission  work,  eon- 
duets  a  vast  deal  of  henefieent  institutional  Work, 
:;iid  transplants  its  branehes  further. 

It  >t'ems  prol>able  that,  like  the  Sister  of  Charitv, 
the  draeoiiess  will  i^M\idualI\"  eonnt  for  less  and 
less  in  nnrsiiii^  proper,  whili'  she  will  eontinue  to 
he  skilleil,  valuable,  and  aetive  on  other  liiU'^-  of 
<iT\ii-e. 

In  <ierman\-,  the  home  of  the  Motherhouse, 
fnrthi  r  and  nv  Te  nrent  lines  of  nursin,^  progress 
ha\r  !)een  Mieeessiwly  marked  by  tlu'  Red  Cross 
assoeiations:  l)y  the  lari^e  eity  schools  for  nurses, 
arranged  ui)on  the  ICnglish  pattern;  by  the  Dia- 
konie  Verein;  and  lastly  by  the  ort^anisation  of 
'■  I-rr.'"  Sisters  which,  with  the  openinjj;  of  modern 
traininsT  si'hools  in  the  lar^e  new  hospitals,  speaks 
the  latest  word  in  nursing  evolution  from  monas- 
ticism  to  \-oluntary  self-government  after  training, 
and  a  progressive  educatioral  standard.' 


'  The  modiTn  nursinfj  movoment  in  Germany,  as  well  as 
th.it  <>i  other  European  countries,  will  be  taken  up  in  an(jther 
volume. 


CHAPTIIR   II 


rKi:-\H'.iiTi.\c..\i 


TIMES 


!\()M     till      linir    .if    till'     diss,  ilutinii     nf     the 


111'  mas'i!  rn'S  uui  li-r 


i('iir\' 


\1!I, 


ilKTr 


"ulUr,    the 

4 


cin'ti"    1iir    iniiiiarnnl    Wdiiirn. 


ha.l 
am- 
his- 


I'lruui,    woiii 


Otb 


n;t\  <■ 


l\:i< 


foundali 

hut  \villioiit  '.  1  A\^ 


ul    il    siuh   Uiiiiiinu' 


lui'-scni  II  il 


attention    m    the    carlv 


:U'  sul'ji  (1  had  i\Cvi\f(i  nuirh 
irt    (ii    ihr    iiinrt(.'t'!it!i 


I 


Cfnturv, 


M( 


Iff  than  tliirt  \-  \a'ars 


Kaiscrs- 


^vc■rth  was  foundi'd.    Dr.  (i  loch.  a  i.h\si(ian  and 
]ihilanthro|)isl,    h.id    bcrn 


'iH'a.iK'    inn  iRssfd    h 


what  he  had  sivu  i)f  the  mn-si'iL'  i )f  t!u'  Hi  >'ui 


ni^ 


ind   Auinisliniaii   Sislrrs   m    tl 


hi'S-'Uals   (il 


Xrlht-r'and^ 


and 


IV    what     hi-    hia.'d    I'min    tli' 


])hysicians  thi'fc  ot  Ihnr  ixrtlKnl  iniahtus  ani 
devotion.  Hi'  corrcspondi'd  ^vith  Smithi'V  mi 
the  suhii'i't, 
loqn 


md   SouthrV  discussed    it   h     the   ('ii/- 


tcs. 


Where 


IS 


th 


c   woman    w  h' 


siia 


II 


the  Clara  <>r  the  Teresa  of  Protestant  Ivn^dand, 
hiI)ourin>,'  for  the  certain  lu'netit  of  her  srx  with 
their  ardour,  hut  without  their  d< '  ision  nr  fatal 
superstition,    which    ha\e   entailed    such    misery 


Prc-Nightingalc  Times  63 

tip'in  t!iousan<is!"'  vSoutlu'V  had  hopes  -  (savsMrs. 
Jameson)  tha.t  Mrs.  ()]>\c  woiiM  dtj  inr  the 
h'ispilals  what  Mrs.  Fry  had  done  fur  the  i)risoiis. 
Ill-  also  Ii  inked  to  the  (Juakers  as  l)ein,<.,'  niore 
likely  than  the  (duu'Lh  of  Ivn.uiaiid  to  fomid  an 
order  of  Protestant  vSisters  of  Cdiaritv.  Sir 
Thomas  M'lre  and  Montesinos  discuss  a  CiViKeeevun 
— ;ie<>lle.ue  rather  than  a  convent,  for  the  educa- 
tion and  Irainni^  of  women  fur  useful  h\-es. 

\V;;y,  th' II,  have  y.iu  no  Hc'LTuim  s,  nu  Sisters  of 
Charity?  Why,  in  tlie  in..st  needful,  the  nmst  merci- 
ful fnrm  that  charily  (an  take,  ha\e  \-(ju  net  vet 
fMll.Aved  the  exaini>Ic  nf  tlie  I'reiuh  and  the  XethiT- 
hinds'  .\'o  Vini  riu  d''  I'au!  lias  hec-n  he.-'rd  in  \-i 'ur 
]'ulpits;  no  Luui.so  le  Gras  has  ajipi.  ired  amt/n;^'  the 
'lau^ducrs  of  Great  Britain!  Piety  lias  found  its 
way  into  your  prisons;  your  hos|.itals  arc  imjilorinK 
it  in  vuin;  no«-hin^'  is  wamuiL;  m  them  hut  reliL^ious 
iharity;  and  .h  '  what  a  want  is  that!  anil  how  differ- 
ent Would  he  the  mord  effeel  which  thi'se  medical 
schools  produce  ujion  the  jmpils  cflucated  there,  if 
this  lameniaiiie  ietieiene_\-  W''re  su]ij)heih  I  kn'/W 
not  vdiether  the\-  or  the  patients  suffer  most  fr^nn 
its  absence.  ...  A  stiiool  of  meciicinc  oui^ht  to  he 
also  a  school  of  Christian  humanity.  ...  It  is  not 
;  ■  the  hospitals  ;ihine  th.it  this  blcsscd  spirit  ..f 
''arit\-   mi^jht    he    direited;   whale    it    ref..rmed    those 

'ahlishments  hy  its  jiresence,  it  Would  lessen  the 
;''<>urc  upon  them  by  seeking,'  out  the  sick,  and 
•'".eiidinfj  them  ni  their  owii  hahitatiens.'' 

^  I'olloquies,  p.  214,  \t\.  ii. 

^  Sistirs  of  C liarit y  (Londnn,    iR^O,  p.  ()j. 

■  (olloquies,  ii..  p.  238. 


64 


A  History   )(  XursiiiL;- 


An  anonymous  urticle,  "  Prottslunt  Sisters  of 
Charity  '"  (bclicx fd  V)  hiiw  \k-vu  written  by  Dr. 
Gooch),  hai!  aiipeared  in  Hauka'i'od's  .\!ai^ii:i)U' 
in  Dcecnilicr,  iSjc,  and  a  year  later  a  jianiphlet 
appeared  luider  the  same  title  eontainin^^  a  "  Let- 
ter" addressed  to  the  Bishop  of  London.  Both  of 
these  artieles  iir,i:ed  the  formation  of  an  order 
of  wonun  dexotc'd  to  nursiii;^  and  j^'ood  works, 
on  the  pattern  of  the  Sisters  of  Charity,  and  some 
elforts  Avere  made  to  indiiee  the  I'^stal  ilished 
C'hureh  to  I'Xperiment  with  this  plan,  but  without 
sueeess,'  Tiiere  w.as  then  no  inklinj.,'  of  an  idea 
that  refined  and  eonseieiitioi's  nursinj.^  could  he 
thouK'ht  of  ontside  of  th<'  hands  of  a  religious 
sisterhood,  and  so  laekitiL'  was  that  tijtU'  in  a 
rational  humanity,  that  the  idea  would  without 
a  doubt  have  soundetl  prt^posterous.  The  wrili,- 
in  />/(Zt'A'av'(ii/'5  said  :  "Tlu'y  [the  nursts]  should  be 
animated  with  reli.^ion;  -.eienee  and  mere  humanity 
caimot  be  relied  on.  ..  .  Let  all  sirious  Chrisihnis 
ioin,  and  lound  an  ■  irdi'r  of  women  like  the  Sist.rs 
ol  Charity  in  Catliolie  eoimtries."  (  )tluT  K'tters 
followed,  and  there  w.iS  a  re\'i\al  o!  the  historv 
of  the  lU'^niine.i  and  Sisters  "f  Chanty.  Dr. 
Ciooeh  also  ur;jed  his  ])lan  for  ih'  rrinrniatior  of 
nursiri;  upon  Ins  iirofessi,  m,Ll  brethi\'n,  in  the 
London  Mcdiiiil  (iazctlc,  o\er  the  sijuiature  "A 
Count r\-  Surj.jeon."  •'  In  this  ijapc  r  he  (Kseribe  1 
some  nursing  cxpcienecs  (jf  liis  owti  in  hospi'  il 

'  ApjX'ndix  of  CoUoquitS,  ii.,  p.  34(>. 

'  (Juotcd  in  Colloquies,  Apid-ndix,  vul.   ii.,  p.  343. 


PrL'-Ni''htin''alc  Times 


•& 


6: 


practice.  Uc  wroLc  in  an  iirlumc,  pn-siKtsive  stvle, 
I'viik'ii; Iv  ])()ss(.'ssr'l  a  iialurf  of  L^^rcal  synipalhv 
aii'l  U!"(k'rnoss,  aivl  had  artiuiri'd  nursiiii,'  skill 
ot  a  hiLjh  or  Icr.  11'.'  woiild  SL'k'C'L  ilu-  saiil)  tA'o  oi" 
three  v.ouK'ii  at  a  time  an.i  ]ihice  theiii  in  a  hospital 
un'ler  some  elear-heaileil,  ,  rat'tieal  ])hysieiaii 
who  shouM  take  them  from  hed,  to  lied,  ex] ilainin.i:^ 
t''»hen;  the  sij^iis  1  ly  which  he  is^uidied  in  hisreme- 
liies;  whv  he  .e,i\'es  opium,  and  \vh\-  hi'  draws 
Mood;  .  .  he  would  assist  their  n.emories  liy 
fre(iueiit  CAiiminations,  and  when  tluy  had  ac- 
([uircd  a  readinrss  in  detecting;  all  ordinary  dis- 
eases, in  seleetin;.,^  the  ^uidin,L;  symptoms,  and  in 
the  use  of  a  short  list  ol  remediit'S,  he  would  place 
them  in  the  inidst  of  some  eounirv  disti'ict,  main- 
tain them  \K  rtly  from  eharitahle  funds  and  partly 
from  the  j)arish,  ar.d  he  lu'liexi'd  th.d  a  few  eurts 
would  be  followed  li\'  nudie.il  r<putation  and 
that  the  villaij;cs  would  i'less  the  da_\'  of  their 
arri\al. 

But  this  was  not  the  way  that  1 'r.  dooeh  nad 
acquired  his  own  skill  in  ;;;/;  ^<';/i,'.  thouLih  he  may 
have  learned  his  nirliiiiu-  li\-  some  sueli  method, 
nor  does  he  seem  to  ha\-e  'h"U,L:lit  of  tins,  \\hen 
he  tells  how  he  Icanud  to  manaj^c  a  patient  with 
a  fri<,'litful  hedsore.  It  seems  actually  to  iia\e 
heen  his  intention  to  create  an  order  of  medical 
I'ractitioners,  for  he  says  further: 


It  may  be  objected  that  women  with  such  an  cdu- 
■  :i  w-ml!    fiirm  a  lia<l  substitute  for  a  scientific 


66 


A  History  of  Nursing 


inedicnl  atlcndant.  Hr  it  remeinl)er('il,  hi^wcver,  that 
the  rhoice  is  mil  belwecn  sucii  w. .niL'ii  aivl  pD- 
I'essii  iiial  or  jjcrffit  pln'sieians  ami  suryei;ns.  but  be- 
twecn  suil)  wdiuLii  and  il.c  urdinary  run  uf  tuuntry 
api  ithecarics,  xhv  laticr  labouring;  under  tlie  additional 
disadvantaj^e  of  -wantinjj;  time  tor  tlie  a])pb.ation  of 
what  skill  thev  have. 


In   his   article   in    Ilhukuvoir.s   he  says    ag; 


tin 


Let  them  reeeive  not  a  tt  >  hni<  al  and  seientiiie  but 


jraeiical    >iii\li<-\i!  edma'i'-n;   let   book 


framed 


for  them,  eontainin.i,'   the   essential    rules   oi  pract !•<•€:  ■ 
let  tiiem  be  distriliuted  in  eountry  parishes  and  be 

^{oes 
wli'    should  lie  resorted  tu  only 
in  di:lieult  eases;  let  them  be  examined  everv  half- 


maintained  \)y  the  i),irish  allowan*  e  \vhieh  m 
to  the  parish  suri;t 


year  by  eompetent  jihysieians,  about  the  state  of 
their  medical  knowledge,  and  I  fearlessly  prediit  that 

mv  friend  [the  i  ountry  c  lergNV'.in]  will  no  lunger 
eomplam  that  h.is  siek  tl^rk  sutlers  from  medieal 
nei^lcct. 

Thtis    medical    reformers    ;ind    plHlaiithropists 


;ulv(X'at(.'d  the  erLatidii 


a  iiursinu  staff  tauqht 


attiT  the  svstt  m  uf  iiiedwai  students,  yet  no  one 
lhi)iii;lu  to  ask,  if  this  manner  ot  ti'aching  made 
nurses.  \\h\'  were  nut  ihr  medie.il  stvid<  uts  nurses? 
There  \ve!\  ntlui's,  no  longer  known  by  nanx', 
who  had  a  more  eorreet  idea  of  the  solution  of  the 
])r()lilem.  A  \vriter  in  ilie  Christian  I'bscrvtr, 
in  an  article  published  in  iiS20,  said: 


<  Tlie  it.ilics  are  ours. 


^ 


Prc-Xii^htir-ii^al*'  Times 


67 


N 


I  am  not,  howcM  r,  ;iwaru  thai  a  si  !■.■■■  ,1  i^r  nurses 
:ns  a  rc<,'ular  part  of  hospital  disciplinr,  tlvniu'h  it 
ajipcars  well  worthy  of  doing  so,  and  wouM  be  an 
r.iealculable  beneht  to  the  community,  i  would 
propose  that  in  every  infirmar_\  any  respectable  fe- 
mal.  who  wished  to  learn  thr  art  of  nursing  should 
he  a[)prenti>  ed,  if  I   may  so  express  it.  for  a  certain 

•  -m,  sa  •  six  or  twelve  months,  and  recei\c  a  course 
..I  theoretical  and  practical  instruction  in  her  in- 
tended profession,  and  if  found  competent,  slioul.i  be 
entitled   to   a   certificate   of   her   ability    and    m"r:i] 

■       -tTiient. 

Among  the  anonymous  answers  to  tie  "  IiKjuiry" 
';-eadv  spoken  of  were  se\er.d  that  wciil  to  tlie 
int.     Said  one: 

Tlic  best  way  to  cfTect   your  object   wnuld  be   to 

■:m  .-in  institution  in  which  women  wouM  be  trained 

become    nurses.     Xone   of    the    institutions    now 

existing  answer  this  purpose,  as  th.ey  train  for  private 

•  cnihes  only.     The  institution  should  be  for  hospitals 
■■'.•  .      .  :r'.\    sutficieniiv  near  to  some  hospital    tor 

the  women  to  learn  the  art  of  nursing. 

Another  wrote: 

It  lias  occurred  to  me  that  a  training  inrtitution 
lor  nurses  might  be  a  i)ra(  ticable  and  useful  iinjiroNe- 
ment.  It  might  be  a  model  hospital,  where  the 
business  of  nursing  might    be  taught,  and    religious 

lining  added. 

To  these  opinion?  was  added  tb.i'  of  Dr  Chattn, 

St.  Bartholomew's  llosiiit.il,  who,  in  iS:;;,  writ- 

:n.;  in  the  London  Mc-'i'^U  i'<i:ottc.  niinlc  a  yk\i 


m 


68 


A  lli^*ur\-  of  Nursing 


I'll"  lunuT  iiursiiiL;  unM  ur,i;(il  that  ihc  lar.uc  hos- 
jiitals  \vrri'  wiTl  ;i'la]itcil  as  traiiiini^^  full  is  aii'! 
ih:;'.  th'jN"  sb.'iv.l'!  ]'v  ulilist''!  1'ir  i'r'>\!'!!!!"'  >'')'"] 
iitirscs.  Ill'  crMicisi'ii  iIk;  liaii  iiit'lliuds  of  tlu' 
liiiic  st'vcruly  and  atirilaiti'd  the  i^fncral  intciii- 
piTanco  <if  iH!rs(.'S  ti'  their  desire  io  stimulate 
thcnisehes  wli;  n  exhausted. 

I)i)th  luuc'hini,'  and  extra"rdinar\'  "was  a  ]irop()si- 
lidii  Set  f'lrth.  in  1S47  Nv  Sir  !'^(hvard  I'arrv  of  the 
Ke.yal  Xa\  \-  and  su]H'rinlenilent  (it  Ilaslar  lios- 
]ii!aL'  lie  had  learned  1  if  the  sueeess  of  tlu-  Kai- 
si  rswerth  exjierinunt  in  tr.iiniuL,'  deaediiesses,  and 
after  drlineatin;^  in  miMe  lan;^uai.:e  tlii'  ideal 
nurse,  \viin;anl>'  and  .i;entle,  he  desenhes  liis  and 
Ills  oflieers'  wish  that  the  naval  hospital  serA'iee 
niii:;ht  be  ini]iro\aM.  ti\-  fujlowini^  the  Kaisirs 
wertli  I'Xainple.  Heeaini'it  douht  die  adds)  tha' 
many  of  his  e(iun!r\-\v<im,  n  \vill  he  ready  to  dexaiti- 
thcmselws  to  the  "work  and  lalKnn-  of  lo\c"  and 
su,i;.u;csts  as  his  jilaii 

I.  To  endeavour  to  enc^a^e  in  the  fii-st  instance 
the  scrvites  of  three  or  f<jur  Christian  women,  he- 
twcen  the  aj:;es  of  thirty  and  fifty,  \v!i<i,  upon  tlic 
jirimiiiKs  .md  eonihtinr.s  ad<ipte<I  al  Kaiserswertli, 
are  v.illin'^'  to  devote  tliemsclvcs  tu  tliis  wnrk  at  Ha^- 
lar  Ih.^pital. 

These  i)crs(ins,  wlien  cnj:;aged.  to  lie  trainei 
for  six  months  at  the  (lerman  hos])ital  at  Dalston. 
according  to  the  system  pursued  at  Kaiserswertli 
(but  lie  forgot  that  at    Kaiserswerth  the  probation 

'  IJospiliils  and  Sisterhoods,  1^55,  pp.  3S-41. 


i 


'd 


i-  ."= 


i'.'.- 

'>:• 


M 


Pi 


y 


Prc-Nightingal(j  Times 


69 


time  alone  -ivas  often  more  than  six  m(intlis),  or 
it"  riri'unistances  jieniiit,  tu  !)e  placed  at  Kai^trs- 
werth  for  tlicir  training. 

;,.  Their  trainins,'  being  (■<)mi)]eteil,  tlie  nurses 
to  be  a'liniUel  to  Ilashir  If  ispital,  where  they  will 
re'ei\e  no  pecuniary  allowanee,  but  a  comfortable 
home,  neat,  ami  respectable  Inthinjj;,  and  a  suffi- 
cient maintenance.  Their  duties  vnll  be  arduous 
and  self-den yin,t,\  ami  they  will  ine-n  with  much  to 
exercise  their  Christian  patience  and  forbearance, 
'uut  tliey  will  receive  encoura,L'cnient  and  support 
from  the  captain-superinten(Jent  and  the  other  officers. 

.\  cill  tor  c'ontrihutioiis  folhnved,  in  tlie  ii(i])e 
that  a  successful  exin  riiriciil  nii.ulit  be  iiriitati-d 
throu.uhout  the  kiiiu'.linii.  It  was  si-iicd  William 
l-dward  I'arrv,  Cai>tain-SuiHTiiitcn(k'nt,  Ilaslar 
Hospital,  1847.  Later  he  wrote  (sadly,  one  can- 
not doubt):  "For  this  plan  we  did  not  i_;et  (iiic- 
olter  to  do  thi<  serx-iee—lhou.uh  hundreds  of  niv 
Jiaper  \:vvv  circulated  far  and  wide,"  fiood, 
iiruve,  and  simple-hearted  sailor,  wit'n  a  tjenuinc 
vision  refieetini,^  only  nobly  on  his  own  cliarattir, 
his  was  the  same  error,  c\-er  old  a.nd  ewr  new, 
"i  thinkinij  that  a  work  wrou.uht  out  of  life  lonj^' 
clfort  and  ilu'  souls  of  raix^  diaracters  like  the 
Fliedners,  or  Louise  !e  C.r.as  an<l  Vnuvnt  de  Laul, 
can  be  cojiied  at  will  and  rejiroduced  anywliere 
I'll  .lemand  in  the  s  .ort  spaee  of  si.\  mont  hs. 

The  first  practical  demonstration  of  trainint,'^ 
nurses  in  Ln«;land  did,  however,  own  a  spiritual 
l-ond  with  Kaiserswerth.     It  was  that  cLtii   by 


lo 


A  History  of  Nursing 


Mlizalictli  (iunuA','  Imrn  on  Mav  21,   178 


o,  an 


farlv  inarriud  to  josr])!!  Fry,  ijosscsscti  a  natuR' 
i)f   wiw    lirauly   anil   s,'oo(lnfSS,   wliith   inij)resst-il 


ilselt   with  c'Xtraiirdmarv  strciii 


II  h 


IT  con- 


temporarus. 


She 


he  Ion  <'('(! 


to 


ll])() 


an     cniiiu'n 


tlv 


liberal  and  ] u"* jorrcssiw  (Juakfr  family  and  cii\'le 
— txlornKTS  rnif  and  all — and  shr,  in  htr  beautiful 
and  ;^Taei()us  ])rcseiR'e,  tx'jutlcd  mercy,  b(,iii;j,nity, 
and  ]iraetieal  wisi'im.  She  ln.ijan  her  reform 
wcrk  ei  liiK  idently  with  her  married  life  by  fol- 
jnwinij;  hon.ie  a  b(L,f,t,''ar  woman  earr\dn<;  a  half- 
frozen  child.  The  \\oman,  wishini,^  to  be*.,''  but 
not  to  be  \'isited,  tried  in  \'ain  to  e\ade  the  liraw 
V()un<j;  woman,  who  sueeieded  in  tracin^r  her  anii 
in  nnearthini;  a  shoekin;.;  trade  in  star\'e(l  infants. 
in  her  country  home  sUe  labom-'MJ  incessantly  in 
lIu'  cotta,L,'es  of  the  pnor  — hers  was  frieuvlly 
\'isitin>.,^  work  in  its  nii '--t  lo\-im;  and  inti'lliLieiii 
form.  She  was  an  ard.ent  belie\er  in  vaccination, 
and  ]")erformed  the  oi^eration  skilfully  herself, 
making  frecj  nt  romids  of  ins|)ection  for  this 
jnirpose  in  Miia.gcs  mar  b_\-,  with  the  result 
(unusual  at  that  dayj  th.it  smallpox  was  almost 
non-existent  in  tlie  rt^ious  round.  -Mrs  Fi-\''s 
s-pecial  life- W' irk.  "ike  that  of  How.ard,  was  *iU' 
amelioration  1  if  the  lot  of  jirisoners  and  thr 
humanisation  of  ])rison  conditions.  She  ocean 
in    iSi_:;  hi;r  famed   \v< 'I'k  in  ilu'   Xewt^^ate  |)ris(in, 


1; 


'Till-  Lijc  oj  KlLabith  Fry,  liy  Sus;i!iii;i  ('(inliT,  1884  ;  and 
.1  Mitnoir  oj  ;lic  Life  o'  Elhabcth  Fry,  in  2  vols.  By  iht 
iJaughUT,    1 84;. 


4 


r'3 


T-' 


i'-j 


l'rc-Nightini;alc  Times  71 

li'-I  to  it  I'V  the  reports  of  Ouakcr  friends  who 
hail  been  in  the  h;ii)it  of  visilini;  there.  Conch'tions 
Were  so  distressing  that  it  niiL,^ht  have  been  thouK'ht 
that  Howard's  Ufe  had  been  spent  in  vain.  The 
description  of  the  female  sitle  of  Xe\v>;ate  pietures 
a  hell     whieh  indeed  it  was; 

Three  hundred  women,  with  their  ehihlren,  in  the 
same  room,  in  ra',(s  and  dirt,  destitute  of  sudicient 
dothin^'  (no  provision  beinj.;  made  for  thisi,  sleeping 
without  beddinj^  on  the  lloor,  at  one  end  of  -.vhi'Ji 
the  boards  were  rai'-.ed  to  form  a  sort  of  ])iIlow,  .  .  . 
here  they  h\ed,  eooked,  and  vashecL  Tbjward  and 
his  Immane  cxt-rtions  apjieared  to  ha\e  been  f(jri,'(jtt'n. 
Ounceons,  (hunp,  elose,  and  narrow  eells  often 
formed  th.e  common  prisons  of  offenders  of  either 
sex  and  of  all  ,L,'rades  of  crune.  The  danirer  of  eseape 
was  j;u  irdcd  again^t  by  hea\  y  iron  fetters,  (hrt  and 
disease  al)oundcd;  these  evils  v.vrc  masjnif.ed  Ijy  the 
cniwded  state  uf  the  prisons.   .    .    . 

The  death  penalty  was  still  fixed  for  trifling 
"ffetiees.     A  nott'  from  Mrs,  Fry's  jourmd  reads: 

Beside  this  poor  youni,'  woman  tlierc  are  also  six 
men  to  be  hai\','cd,  one  of  wiiom  lias  a  wife  near  her 
("ntinement,  who  ;.,  also  rondenmed,  and  se\  en 
;■;.'  hihh'en.  Since  the  awful  r^jiort  came  down 
i;c  has  heen  quite  mad  iVoUi  horror  of  mind  and  has 
bitten  the  turnhe\-.  A  strait-jacket  could  not  keep 
him  within  ij'^undsd 

In  tliis  jilace  Mr'..   Fry  ;',nil  her  friends  estab- 
1  /,//.'  of  Mrs    l'r\ ,  l.y  S   i-,i,i,T,  p.  ?4j. 


^ 


/  - 


A  IlistoFA  of  \ursi 


'l^^ 


llSlU'' 


clas 


;i  srliMoI  fur  the  I  liil(!nii  and  started  sruii; 


isscs,  |)ri.\  idiii'.:  iiiatiri; 


I'll"    wov. 


and 


i' 


ir 


\h.v  W'nv. 


'1 


rv  n 


!i,  1 


,1  <  1 


jH"!  LiUn;  i()  cai'n  and  s^ini.' 


aui 


1    lirtric'iid.cil    tlu'Hi   tijinn    release.      r]\er\-   d; 


prisi  in. 


ars  ther 


e  was  s^nie  one  of  this  eircle  in  tin 


and 


tiK 


enaiu'e 


leetci 


little    s 


hort 


inn-aeul(nis,  attracted  the  attention  (/  iiliilanthm- 
])ists  in  all  ed'.mtries.  In  iSiS  .Mrs.  Vvv  wasealleij 
t'>  M've  testimony  as  {,>  the  jirisons  before  the 
lit  luse  <  if  Conunons 

On  his  \-isits  to   iln-land    pastor  Idiedner  had 
learned   of   this   av.  ^rk  and    had   ir.et   Mrs.    Fry,   of 
whom  he    vrote.  "  (  )f  all  in_\-  eijnter.'i)oraries  nont 
has  e.xereiscd   a   like   iilluenee  on   niv  heart  and 
life.  ...   In  January,  iSj),  I  had  the  ])rivilcRe  of 
V'itnessin.i:    the    elf(>cts    of    her    ^von(ler-workin.l: 
\isits  anion.i,'  the  miseraMe  ])risr,nc-rs  of  Xe\\,L,'ate." 
Ill   iS4o,  on  a  trip  to  the  continent,  Mrs.  Fr_\-  had 
\isited  Kaiserswertli,  tothei^reat  i(n- of  the  {jastnr 
and   his   wife.       lie  wmtc:   "My   hapjjiness    may 
l>e  ima.umed  when  she  came  in  person  to  sec  and 
rcjoiet'  owr  the  ^rowinjj;  (  stablishment  of  Kaisers- 
wertli.     Slu     saw    the    A\li'.]t'    liouse,    Ljoin^    jp*,) 
e\-er>-  niom,  and  minutely  e.\andnini,r  e\cTy  detail." 
Mi-s.    lu-y's   haliitual    ac; |uaintance    with   sickness 
am.  n-  the  ji'.or    and  her  hours  at  their  bedsides 
had   Inu'j,  im]iressed  the  need  and  importance  of 
nursin-  on  her  thou-IUs.      Xow,  what  slu'  heard 
and  saw  at  Kaisrrswrrth  made  lu'r  most  desirous 


'1  I 


x\;(innin,i,'  something;  n\  the  kind  at  honn 


H 


er 


own  Work  m: 


It  imp 


'ossihle  lor  her  to  i^u'e  much 


t 


I'rc-NiijhtinLralc  I 


IIIH'S 


/  o 


tiiiiL'  to  tlu'  jtroji'd,  \>vA  thr(iu,i:li  licr  sister  nivl 
(iaiij^'htiT  it  was  taken  up  ami  hrouu;]!!  to  truitK 


111. 


Xi 


in  \!^\o  an  in.^Lunlf  oi  .\ursnii;  was  esiaiilisiu'd 
in  Devonshire  Square,  IHshops.i^'ate,  and  the  pujnl 
nurses  were  first  ealle.l  "  I'rott'Slant  Sisters  of 
Charity."  Tlie  name  ,i-;a\'e  rise  to  sus])ieion  and 
Sectarian  preiuihee  and  was  later  ehan^^ed  to  that 
>'■.  "  XursinL^  Sisters."-  The  nurses  were  doniieiled 
i;!  the  I[onie,  where,  on  the  ])hLn  of  Kaisers\\(,rt  h, 
they  Wire  careluHy  supervised  and  niolherccL 
Their  hospital  trainin<j;  was  received  at  Guy's  Hos- 
pital, and  was  of  the  sort  which  has  characterised 
the  bc.^inninjjjs  of  the  trainin^^  in  nursini;  in  aln.o:it 
t'.<ry  country,  namely,  what  one  mi.^ht  e.'ll  hos- 
pital visitinLj,  for  these  pupils  had  no  organic  re- 
lation to  the  hospital,  Imt  went  there  daily  for  a 
short  ti nn  of  se\'eral  n^onths  (later  lengthened  in 
.■iceonlance  with  the  rising  standard),  to  work 
laider  die  untrained  nui'ses  of  the  wai'ds,  and  to 
be  ta'ight  l'\-  the  p)h\sieians.  It  is  not  evid.ent 
th.it  they  had  any  theoretical  instruction  or 
classes.  The  Sisters  were  most  carefullv  clio.st^n, 
and  \\e  may  well  believe  that  they  made  up  in 
earnestness  for  the  desultory  eharat'ter  of  their 
training.  They  were  jirepared  only  as  attendants 
I'lr  priwate  .rmrsing,  and  made  little,  if  an\-,  im- 
pression in  liospital  work.  In  the  fact  that  they 
(lid,  howe\('r,  ha\-e  some  experience  ni  a  general 
hospital,  thev  were  ahead  of  the  school  in  I'hila- 
iHphia,  in  the  United  States,  which  at  that  same 
'  (order's  Life,  p.  305. 


2  ll'iJ. 


565. 


MICROCOPY    RbSOLUTION    TEST    CHART 

ANSI  ond  ISO  TEST  CHART  No    2 


1.0 


I.I 


1.25 


*■    "3.2 


■  a6 


1.4 


2.5 

12.2 

2.0 
1.8 


1.6 


^         .tlDCJl     IC 


FT  INA^GE     Inc 


74 


A  Ilistor)'  of  \ 


ursiii'!- 


time  v.-as  (IcvL'lopn.^r  ^,„,i,,,.  (,^^.  ^.,,,.^,  ^^^  .^  ,^^.^^^ 
<'t  OuakcTS  uf  tlui  city  Urr  ,, rival.-  nursinn-'  other- 
wise the  .uvneral   Hues  -m  uhr  h  ihr  tun  .Toups 
were    arrani^e-l,    the-    h-mu     training    an,l    serious 
spini,    the    earnest    ,,uri.,,se    an.l    jiraetieal    ^o<m] 
srnse   ,.1    thr  {■nm.lrrs.    -n,  ..   th.sc-   two   earlv   ex 
pcnments     a     .^,„.!      deal      of     siinihtritv    '    We 
do    not     kp.MU-     that     then,     was     anv    'rrlation 
between    ih,-     Kn-Ii^h     an.j     thr  Ana  nean    earh 
nursin-     seh..Is     oi    th,-    (Jnah.  rs,    ].„t    as    Mrs 

i)i,a 


liiiaiKlj.hu;.  it    is  not    ini- 


Fry  had  a  hrother  m 
pr()bal)le. 

Naturallv,  no  iniit  at  inn  ,  ,f  churehlv  onlers  wnuld 
arise  un.lrr  the  niana-enimt  of  the  Friend^       The 
extent  towlneh  Mrs.    Fry  was  ,n  a, Ivanee  uf  her 
time  was  shown   |,v  the  ,ol.hi.<s  in  the  attitude 
taken    hy   r.I-,o„s    .vriter>   tow,  nl    the    prnemles 
;;:,  ,;^'^'^''     "><•     "^'"-^'"K    S.stcrs    w.re    lounde.l 
While  oth.rs  insisted  on  the  neeessilv  for  iK.ldin- 
mn-ses  ,n  the  sinet    hands  of  reli.^ious  <l.sei,,lau'^ 
Mrs.  1-ry  started    iiers  wiihoiit   l„,„d  or  tornis    of 
eercmonial.    though    the    spirit    wh.eh    animated 
their  Lome  ^vas  a  devoutlv  pious  one.      ihrs  was 
a   seeular   order,    and    she    intended    to   ereate   a 
method   by  whieh  a  reasonable  maintenance  for 
the  nurses  would  be  eombine.I   with  an  effieient 
and  olten  gratuitous  care  of  the  sick.     Thr  Sisters 
were  to   be  maintained    by   the   institution   and 
were  not  permitted  to  rc-ceix-e  anv  m(.,K-N-  or  gifts 
They  were  to  work  in  the  spirit  of  the  Si.sters  of 
Charity,  yet,  after  all.  theirs  was  u  lay  sisterhood 


Prc-Xi-htiiii^alc  Times 


75 


and   their   training;   was   (nilv   fnr   nursini. 


For 


this  reason  Pus(,'\',  wht 


iS  at  tliis  tinu'  interest ■ 


ini:  himself  in  projects  of  nursing,'  ri'funn,  did  n<  it 
entirely  ap])rove  of  them,  as  their  m.  .d^.  of  hfe 
CYmteniplated    only    so    nuuli    srh'-dmial 


necessary    for    a  ntirs 


V  s 


wi  irk 


(r\ 


en     so 


mav  liave  been  ralhir  more  tlian  tlie 


L'(  I'  I' 


(luile  realised).      Miss  Stanl 


cv 


who   m    SI 


IS    was 

mueh 

dix'ine 

H  tkiiiL' 


of  th 


'Th 


«)i  mem  savi:  i  lie  r-mjnsn  iToteslani  Mster 
of  Charity  were  only  ]  1,1  id  mn-ses  tielongini:  to  a 
society  established  li\-  Mrs.  Frv,"  added,  "  The 
further  and  liiL'jier  idea  slic  did  not  ]\\x-  to  estab- 
lish." ^  l".\en  jiasior  I'liedmr  was  n]tiniati]_\- 
disajipointed  in  them.  f.  .r  he  lol.d  A-ncs  fours, 
in  i860,  of  his  r.  -nt,  :ifter  the  eonsnltations  he 
hail  had  with  Mrs.  l-^ry  about  her  nursin;:  wnrk, 
to  find  it  such  a  limited  ov.v:  he  thou-ht  In  r 
nurses'  sphere  restricted,  in  comparison  to^hat  it 
niiijht  be.  and  rei^retted  also  iliat  no  attempt 
was  made  to  improve  them  by  mental  culture.-* 

Mrs.  Fry  did  not  li\-e  lonij  enouj^di  to  see  mor(> 
llian  the  lieirinnin,^  of  her  nursinsj;  reionnutiMn. 
Shediol  in  iS|5.  and  her  Life,  as  it  was  written, 
makes  only  sliij;ht  mention  of  the  .Xursin,;^  In- 
■'itute  and  throws  no  li.uht  ui)on  its  details. 
\,,r    ,loes    the    hospital      history    mention     Mrs. 


'  Mnuoirs  of  Afittes  E.  Jones,  1885.  l.y  lier  Sistor,  p.  383. 
'  i.ij.ojK.  li.  Puscy,\>yCnnon  I.idduii.  kS(»4,  vol.  lii.,  ihap- 
r  on  ••  Early  Days  of  Anglican  Sisterhoods." 
'  Hospitals  and  SishrhooJs,  p.  59. 
•  V'rmoirs  of  Agms  E.  Jones,  j..   135. 


76 


A  IIist()r\-  of  Xiirsin2f 


I- 


s  nursi-s. 


en 


th 


cvv. 


SlKXX'SSl  ul 


;iiii| 


By    1S57  niiu'ty  nurses  had   lie 
all  of  ^vh(lnl  mxtc-  engaged  in  ])ri\-ale 
n  existence  as  a  ^■erv 
managed   trainnig  ir.stilutioii 


die  Institute  is  si  ill  i 


well- 


f- 


or  ]n-u-at.e  nurse; 


Tlu'  next  MM\-e  of  efffirt  rose  in  tlu>  l'-stal>lished 
riiureh  and  I'rougl'.i  into  existenee  mueli  inttrest- 
ing    and    hisiorieallv    significant    niu'sing    organi- 


sation    and     training,    for    the    earl 


An 


uncan 


sisterh 


ood.,  I'xperiniented  in  man\-  forms  of  soci; 


serx'ice,    mcludnig    \isitnig  nursui 


lh 


e\-  entered 


hos])itals,  ga\e  a  demonstration  of  refined  and 
educate(l  gentlewonien  taking  up  the  des])ised 
duties  of  llu'  nurse,  and  souic  of  tluir  meml)ers 
Were  piouet'rs  not  only  in  the  hund.K'r  but  also  in 
the  higher  fields  of  hospital  maiiagenn'nt  and 
ward  guidance.  They  had  some  well  i>ripand 
Women  ready  to  go  to  the  Crimea  \\uh  Mi^s 
Nightingale,  ainl  from  one  of  their  groups  canie 
the  Sister  who  later  successfully  organised  die 
Belle\-ue  scdiool  of  nursing  in  the  Uniti'i]  States. 
l)r.  I'usey  \\rote  to  Kelile  in  \^\()  of  his  con- 
viction that  it  w.;s  necessary  to  have  Sisters  of 
Charity  and  employ  them  as  nurses  in  hospitals 
and  lunatic  asylums  "in  whu  h  l.,st  Christian 
nursing  is  so  sadly  missed."  f  [<  also  corresponded 
with  a  physician,  Dr.  Cireeiihill,  on  the  same  sub- 
ject, and,  through  him,  obtained  a  copy  of  the 
rules  of  the   Augustinian  Sisters  and   the  Sisters 

>Hiot;ruphical    History    of    Guy's    Hospitnl,     Wilk.s    .u..l 
Bettany,  London,  1892. 


S 


Prc-Xii/htin-'alc  Times 


/  / 


'M  Charity  of  Vincent  i\v  Paul.  The  first  sistcr- 
ho>)(i  in  the  I'^n^hsh  Church  arose  undt'r  Pusey's 
1,'uiilance  in  1845.  ^^  "^^'''•^  called  the  Park  X'illaL,^' 
Cnniniunity,  aiiil,  under  the  care  of  a  committee, 
was  housed  in  Rei^^'ut's  Park.  Pusey  had  gone 
ahroad  in  iS.i, i  to  study  French  sisterhoods  and 
nursing  orders.  Put  the  Uanings  of  his  mind  drew 
him  from  the  mMi\-  acti\-e  orders  of  Augusiinians 
and  Sa'urs  to  th.e  rule  of  St.  Francis  de  Sales'  Order 
of  the  \'isitation.  from  which,  as  we  have  seen, 
active  nursing  work  had  been  displaced  l>v  ascetic 
regulations,  and  it  was  a  modification  of  this  rule, 
])ri)viding  for  aPiait  four  hours  daily  oi  \isiling 
among  the  poor,  whic-h  was  finally  adopted  for 
the  Park  \'illage  Comjnunily.  There  was  no 
training  in  nursing  ])ro\id,cd  for,  noi  e\-en  a  course 
of  walking  the  hosi)itals,  but  there  was  friendly 
\isiting  of  the  ])oor  and  sick,  at  home  and  in 
hospitals  and  workhouses,  bur\ing  the  dead, 
Ragged  Sc'hi'ol  \\ork,  etc.  The  numbers  were 
called  Sisters  of  Mercv.  Oladstone  was  among 
the  iinportant  sympathisers  with  the  movement. 
In  1X48,  Miss  Sellon  l)egan  a  similar  work  at 
Devonport.  by  gathering  a  group  of  devoted 
women  together  for  service  among  the  poor.  The 
Bishop  of  Exeter  a])pro\i'il  tluir  labours  and 
])ermittcd  thtni  to  form  an  order  of  Sisters  of 
Mercy  under  the  wing  of  the  Chun  h.  Miss  Sellon 
and  her  Sisters  were  acti\e  in  Iktbnal  Green  and 
Pl>iiu)uth,  and  later  in  the  east  end  of  London. 
Although  the}-  had  no  regular  training  as  nurses, 


78 


A  Ilistorv  of  Xursin<jf 


the}'  took  every  opportuniU'  of  L;i\in<j;  service  in 
sickness,  and  in  1840,  during,'  an  epidemic  ot 
ehoh  ra  in  I'lyiiionth,  tliex'  were  coura<,'eous  and 
unUrinjj;  i.n  seckins^  out  tln'  sulYerers,  \  isitini^  and 
aiding  them.  That  tlicy  then  attempted  nursinj:^  m 
the  strict  sense  is  doul)tful,  Init  they  did  not  spare 
themseh-cs  in  meeting  all  kinds  of  emergencies 
and  in  elYorts  to  relieve  distress.  That  thev  later 
develo]H'd  a  somewhat  systematic  ]irei'aration  fo'- 
the  care  of  the  sick  is  exddent  from  the  fact  that 
the  Superior  and  a  number  of  Sisters  accompanied 
•Miss  Xightingale  to  the  Criiiiea.  About  this  time, 
they  had  a  hospital  at  P)ristol  and  a  Xursin.;.; 
Sisters'  Home  connected  with  the  church  of 
St.  Barnabas,  Pimlico,  where  a  few  jiatients  wc-rc 
received  and  from  which  nurses  went  out  to  nurse 
the  poor  in  their  homes.'  In  iSf)C)  tin-  cholera 
raged  iti  Loniioii,  and  Pusev  helped  to  found  a 
cholera  hos])ital  there.  H\-  tins  time  there  had 
been  a  fusion  between  the  Park  X'illage  and  Miss 
Sellon's  communities,  and  Pusey  offered  tlie 
services  of  Miss  Sellon  and  her  Sisters  to  take 
charge  of  the  hospital,  which  they  did,  for  they 
had  worked  as  volunteers  through  a  number  of 
epidemics,  and  were  fearless  and  energetic. 

As  this  Sisterhood  had  developed  extremely 
high  church  tendencies,  it  had  many  enemies; 
and  attacks  were  made  upon  it  in  print,  which 
still  survive,  sounding,  it  must  be  felt,  absurdly 


'  Hospitals  and  Si.'>ti-rlioods,  p.  52, 


^ 


Prc-Xicrhtinii'alo  Times 


79 


hysterical  and  sciisational.''  It  is  perhaps  trur, 
lidwc'vcr,  that  some  of  the  crri'iiionials  instituted 
:i\-  MissSellon  and  Dr.  Pvisev  Knt  themselves  easily 
to  the  riilieule  uf  tlie  irreverent.  Nevertheless 
the  exquisitely  refinini^  intluence  of  the  Sisters' 
atmosphere  should  not  I'e  fori^^otten  by  critics, 
<T  this  mtist  ren.ain  as  tlieir  most  precious  con- 
•ribution  to  the  S(.>cial  life  around  them.  The 
love  of  beauty,  \\ith  the  consistent  determination 
•'I  bring  it  into  the  li\'es  of  the  people,  and  a  scnsi- 
iive  considerati(  in  fi  ir  the  feelinps  of  the  poor,  were 
aiiiding  ])rinciples  \vuh  .Miss  Scll<in,  and  so  sordid 
and  hideous  appears  t'>  haxe  bet  ii  the  lot  ot  tlu' 
poor  bv  win  on  she  was  surrmmded  that  tins 
should  ever  be  remembered   of  hrr  gratefully. 

The  community  of  St.  Jwhn's  House,  founia-d 
in  184S,  was  the  first  ]iurel\'  nursing  order  in  the 
Anglican  ("hurdi.  and  has  h,,d  an  im])nrtant  and 
■nteresting  part  in  the  de\elo['n-',ent  <if  1-inglish 
nursing.  Dr.  Todd,  n\  King's  College  hospital, 
was  conspicuous  in  the  preliminary  movement,  as 
was  also  Mrs.  William  Morrice.'  In  a  Utter  jin- 
\atel\'  circulated  in  iSj;,  Dr.  Tnd.d  originall>- 
projected  an  establishment  h  >r  tr.jnir.g  mu'ses 
in  connection   with  King's    College  hos]iital,   ai'.d 

'  S«.i-  Sisterhoods  in  the  Church  of  Eni^lami,  by  Margaret 
Goodman,  I-omlun,   1^04. 

'A  I'amiihlct  entitled.  "A  Brief  Account  of  the  Design, 
Origin,  an('  Pn)gress  of  the  'rraining  Institution  for  Nurses 
fir  Ilospiv..  s,  Families.  aii<i  the  Poor,"  published  hy  Ri<'hard 
i  I.e.',  in  a  report  dated  Nov.,  iSco,  gives  Mrs.  Morrice  as  the 
Lady  Superintendent  at  that  date. 


J 


8o 


A  Ili^torv  of  Xursincr 


)f  Bishop   P)lomliel(l   and 


m 


under  the  auspices 
concert  \vilh  ott;er  friends  he  took  a  leadin^^  jj;,,-^ 
in  drawiuLT  up  the  fundamental  rules  and  in  fram- 
ing,' the  arrari-enients  under  wliich  St.  Jolui's 
House  was  set  on  foot  in  the  folhAvin;^  year. 

Dr.  IviwuKin,  ;ilso  of  Kuv^'s  Collcire  hospital, 
was  likewise  wry  aeti\e  in  working.:  for  nursing 
reform,  and  <>uv  of  the  e;;r'i('St  slips  in  the  ffmnda- 
tion  (>:'  St.  ]ohn's  House  apjx'ars  to  ha\e  been  a 
(ireular  Irttir,  of  which  no  coi>\'  sur\i\cs,  written 
l.y  Dr.  I)0\\inan  to  eminent  nu-dieal  men.  The 
tirst  ])ul)lie  action,  which  was  apparently  the 
result  of  this  letter,  was  the  .Uuthering  of  a  very 
im])ressive  array  of  bishops  and  clert;y,  lords, 
an<l  members  of  the  royul  family  on  the  i.^h  of 
ful\-,  iSjS.  At  this  nuctins.,^  the  followinj.,^  jiro- 
posal  was  (-onsiiiered  : 


=  5 


It  is  jirnposcd  to  establish  a  enrporate  or  rolle.t^iaU' 
instiiuti  '11.  the 'ibjeils  of  wliich  W' luM  be  to  uiaintam 
ill  a  riiimnunity  women  v.  ho  are  members  of  tlie 
Church  of  Kn,i,'land,  w!io  slu'uM  receive  such  in- 
struction and  undergo  siu  h  training'  as  nii^ht  best 
fit  them  to  act  as  nurses  and  visitors  to  ilu'  sick  ami 
poor.  It  is  jiroptiscd  to  connect  the  institution  with 
some  hospital  or  hosj)itaIs,  in  which  the  wnmcn  undtr 
training,',  or  those  who  had  been  a'.riaiiy  tducated, 
mi^ht  find  the  opportunity  of  exercising,'  tluir  calUni; 
or  <>f  acquiring  experience.  It  is  absolutely  necessary 
to  the  success  of  the  design  and  the  real  amelioration 
of  the  class  of  persons  for  whose  benefit  it  is  intendeii, 
that  the  proposed  establishment  should  be  a  religious 


rrc-Ni^htiiiLralc  Times 


8i 


,,nv,  and  that  all  r.mncctr.l  witli  it  sImuM  reijard 
the  wtirk  in  which  they  are  eral.arkiMl  as  a  rcH-^iuus 
w.irk.' 

The  society  llms  forntoi';  under  the  most  dis- 
tin;4uishe(l  atis^iiees  later  issued  a  i)anii'hl(,t  deahng 
nujre  ftilly  ^vith  the  ]:iro])()Sed  ])lans.  A  e<.niir.Uti  e 
of  sixteen  ekrgyir.en  and  jjhysieians,  a  .ion;4  whom 
u-ere  many  noted  men  but  Avith  whom  no  woman 
was  associated,  was  formed  to  arran-e  the  -letails. 

Lord  Xelson  \v;,s  warmly  interested  i:i  this  i)lan, 
and  wrote  so.m  after  the  meeting  to  Dr.  Words- 
\\(  )rth : 

Mv  DEAR  Dr.  Wordsworth: 

We   shall   publish    In  tlie   juipcrs  as   sncn    as  pos- 
sible  a  meetin.i:   "t   the   Council,   havintr   lirst    ioumi 
at  the  most  (•<ai\-enient  day  for  the  Bis'nop  nf  Lundon 
:ind  the  ])rincii>al  members  to  attend. 

We  must  then  ;iass  the  formal  resolutions  as  tc 
quorums,  etc.,  and  tix  four  (luarterly  mcetin.us  or 
r.vmthly  ones,  etc.;  dei'ide  how  to  be;.:in  work;  slate 
what  funds  will  be  sullicicnt  t  >  warrant  a  IjeKinnin.u; 
apj.oint  a  place  for  applicants;  c(msidcr  the  imi)ortant 
rules,  especially  the  dietary  and  board  money,  which 
a  ^reat  many  think  too  hi.uh  .  .  .  Iix  on  our  locahty, 
etc.  All  this  should  be  done  before  the  effect  ..f  our 
meetinir   cools,   remcmberini,'   always   that   if   wc   do 

'.\?  St.  John's  House  has  taken  an  important  part  in 
mirsinn  history  we  have  (juoted  freely  from  the  articles 
■  St.  John's  House  in  the  Past"  in  the  St.  John's  House  -Vctei-, 
hcKinnin;,'  in  0(  tol)er,  T()o2,  and  continued  to  date.  The 
Sister  Suju-iior  in  Knintinjr  this  permission  des.  'S  it  lu  be 
noted  that  these  records  are  l>ul  IraKinentary. 


82 


A  History  of  Nursin 


not  get  a  start  sr,on  ^vc  shall  be  sadly  thr-Avn  bai  k 
by  the  absence  from  t<Avn  of  many  members.  I 
think  the  Council  ou;4!it  to  apjinint  some  tlvc  a  Com- 
mittee to  meet  at  all  times  an.l  to  report  to  their 
monthlv  or  quarterly  meetincr,  and  I  should  l>e  <lc- 
liuhted'to  be  one  of  the  workers,  or  if  my  absence  fr.-ni 
tov/n  should  render  me  unlit,  I  should  be  hapi)y  to 
assist  by  \vritten  su-t^^estions    sending  out  circulars, 

ete.  .       ^         ., 

Do  see  if  vou  can  stir  up  people  l.^r  our  first  Council 
mectimr,  f"r  I  am  sure  time  is  most  preci(;us  to  us 
just  now,  lest  peoples  ard.^ur  col  after  reading  our 
speeches,  and  check  their  charitable  feelings  by  the 
remark  "but  nothing  has  ccjuie  of  it." 

Believe  me. 

Yours  sincerely 

Nelson. 


Some  few  months  after  tlic  date  (f  this  meetin.i;. 
during  which  time  the  organisation  and  raising  of 
funds  v.-as  carried  on  with  much  zeal,  the  "Training 
Institution  for  Nurses  in  Hospitals,  Families,  and  for 
the  Poor"  began  its  work,  finding  its  first  home  m 
36  Fitzroy  S.piarc,  in  the  distnct  of  St.  J(jhn  tlic 
Evangelist,  in  St.  Pancras,  frcjm  which  it  took  its 
name^of  St.  John's  House.  (This  was  in  the  year 
184S.)  At  this  early  period  it  -lerived  most  impor- 
tant help  from  the  ilevoti<m  of  Miss  Elizabeth  Frere,' 
who  for  the  lirst  si.x.  months  personally  sujicrintendcJ 
and    developed    all    internal    arrangements    for    the 

'  Sec  also  a  pamphlet  published  by  Harrison  and  Sons, 
called  -A  Short  Account  of  the  History  and  Work  of  the 
House  and  Sisterhood  of  St.  John  the  Iv van>;eUst."  p.  3- 


Prc-Nitrhtin'^alc  Times 


't> 


u^.asc.  Although  -Mrs.  Fry  lia.l  been  first,  in  the 
ficld  with  her  Institute  for  Private  Xun^es  in  Bishops- 
^rate  (founded  in  1S40),  St.  John's  House  was  the 
first  attempt  of  an  Institute  for  Nurses  on  definite 
Church  lines,  and  it  may  claim  a  distinct  position 
of  ha^-inj^  a  reli.i^dous  foundatum.  All  the  nurses 
v.-cre  members  of  the  Cliurch  of  En.j^land,  and  were 
under  the  supervision  of  the  "'Master"  of  the  House, 
who  was  to  be  a  Clergyman  in  Priest  s  orders,  and 
was  to  give  definite  religious  instruction  to  th.c  nurses 
and  to  conduct  their  services.  The  first  Master  was 
the  Rev.  F.  W.  Twist.  Miss  Frcre  acted  as  first 
Lady  Superintendent. 

The  writer  of  the  articles  quoted  fmm  thinks  the 
f.r.st  probationers  were  sent  to  the  Middlesex 
Hospital  for  tniiniiiK.'  An  old  letter  in  the  Xnrsi):;^ 
Record  s;iil  ihev  were  sent  to  the  Westminster. - 
It  would  seem  ])robal)le  that  a  stnall  t^^rniqi  of 
probationers  mii^dit  ha\  e  been  takt'n  by  e:i(  h  ct 
these  hospitals. 

The  Bishop  of  London  acted  as  President  of  thr 
Society.  The  Master  was  to  be  either  married, 
or  a  widower,  and  the  Lady  Superintendent  was  to 
regulate,  with  the  concurrence  c)f  the  Master,  the 
(lomestic  arrangements  and  the  a])pointments  of 
nurses. 

There  were  to  l)e  three  classes  of  members: 

I.      Probationers:     these     must      be     at     least 


'5/.  John's  Housr  Lvatiiu'  Xi-ws,  April,  igo.^.  p.  ^  j. 
'The   Xtirsing   Record.     London,    May    ,;o,    iS.-i., 
signed  K.  H. 


Icticr 


84 


A  History  of  Xursino; 


ci-'htecn  yccrsoM  an.laM.  to  m.l  '.rv.nlo  (it 
is'cvi^ent  from  this  proviso  Uk.i  ihis  class  ^vas  not 
„f  a  hiu'h  social  grade);  ihcy  ^vc■rc■  U.  b.  iiiKlcr 
,rain,ng  two  vcars.  receiving  l.oar.1,  l.Mhnni^  and 

laundrv,  and  paying  fifteen  pounds  a  year.  At  the 
end  of  the  two  years  they  might,  it  approved, 
enter  the  second  class,  called 

o      Nurses:     To    this    class    suitable     women 
might  also  be  admitted  ^vithout  {probation  (these 
^vould    probablv   be    from   the   class   of   educate<l 
,,r     gentlewomen)   and  all     nurseS     must    remain 
•a  least   ffvc  vears.     They  nvouM    rcc'cive  board, 
lo<l-ing,    and    wages,    an'i    at     the    end    (f     five 
vears,' if   c-mpeteP.t   and   d.eserMng.  a  certificate. 
'    V     Sisters:     these  might  either  be  residents  m 
the' Home,  paving  fifty  pounds  a  >-ear,  or  they 
might  live  with  their  families  ;.n.l  trunds.     lluy 
must   remain   at    least    two   years,    and    were  ex- 
pected to  be  examples  to  the  other  two  classes, 
sh.'ring  in  the  religious  and  professional  instruc- 
tion and,  the  work  ni  families  and  hospitals.     The 
connection   with    King's  College    hospital,  whuh 
lasted  until  18S:;.  , kites  from  1840.  at  which  tune 
the  first  probationers  were  sent   to  this  hospital, 
so  closely  connected  with,  the  histor\-  0I"  St.  John's 
House      The  Cexincil  meetings  were  often  held  m 
the  hospital   hall,   and    Dr.   '•^^d,    wh._.se   statue 
stands  there  ive.v,  ^vas  always  there  to  give  achice 
and  help.     The  whole  charge  oi   the  wards  was 
not  given  to  the  Institute  at  first,  but,  as  wilh 
>p-s.    I'ry's   nurses,    the   probationers   and   nurses 


Pre-Ni<rhtinu:alc  Time 


IT 


IXTTlIll 


U'd  to  si^'iid  some  timt'  daily  in 


lh 


wards  in  ihr  care  of  thr  sick.' 

It  may  \>r  <,f  inttTcsi  u>  k-.vw  what  tin-  arranK't- 
ments  f"r  the  day,  etr.,  were  in  those  cailv  liai'S.  A 
i-opy  ..t   the  Time-table  ui  the  Master's  >lay  in   i^v) 

roads: 
•'  7  -.30.     Prayers  in  Chapel  -  .r 

"8.00.     Service  in  St.  John's  Chunh. 

•'  10,00.  Interview  with  the  I.adv  Siiperintcndent, 
when  all  details  alx.ut  tlu.  ll-use,  Xur-^es,  et...  were 
(hseussed     and     settled.      Instru.  thai     f.     individual 

nurses. 

••  12.00.    Instnutiimfi.r  Sisters,  Tuesday,  Thursday, 

Saturday,  i-n  the  I'araldes  of  our  horch 

■•  1. 00'.  Dine  with  innudes  (at  least  three  times  a 
week).      Sliew  house  to  visitors. 

"  voo.     Instruetiou     for     Probationers,     Tuesday, 
Thursday,     Saturday,    on    the    Book     oi     Common 
Prayer,  or  private  interviews  with  nurses,  etc. 
"'4.00.     House  Committee  (Mondays.) 
"  ()fti>e  hours:  ic.oo  to  1.35 — ,"1  to  5." 
The  Master  appears  to  have  had  charije  of  many 
li.,usehold  matters  for  he  "  saw  Treloar's  man  to  meas- 
ure    hall     and    staircase     for    cocoanut     matting"; 
■'arranf;e<l  with    (day's  man  about    n-nntin.tr    Cha[)el 
window";  "interviewed  Sarah    .   .   .    wdiom  1  admon- 
ished."   He  sent  out  the  accounts,  saw  applicants  for 
admission,  and  in  his  diary  are  terse  comments  on 
some  of  them: 

Oct.   10.— Saw  M E candidate  for   II10 

Mtuation  of  nurse;  well  recommendeil  .    .   .  but  ap]iears 

'  The  British  Maiidziuf  gave  the  scheme  of  tramuiy  m  July, 
1848. 


86 


A  Ili.story  of  Nursing 


too  diminutive  in  jKTsnn  to  dischar-re  the  duties  (;f 
nurse  eliicientiy;  sent  to  consult  Dr.  -rodd,  %vh.j  is 
ot  opinion  she  may  eome  lor  a  (ortnii^ht  on  trial.  .  .  ." 

"  Dee.  6.-E H applie.l  as  nurse,  .   .   .  but 

appears  sclf-conccited  and  ill-temi-ered.  No  room 
for  such   at   present.   .   .   . 

It  was  later  f  -und  best  that  the  Lady  Su})erin- 
tendent  sliouM  be  responsible  for  many  of  the  details 
vhirh  ha<l  first  been  undertaken  by  the  Master,  but 
whieh  lay  more  in  the  province  of  the  lady  of  the 
house.   .   .   .  ' 

When  the  .ris'  ,  il  the  Crinuan  wav  e.mic,  St. 
Inhn's  iiwuse  made  the  th-t  ctTer  of  service, 
i'lif  Mastir  (the  Reverend  C.  1'.  Slurherd)  ^vrott' 
a  ].r-iM)sal  to  the  .-onl  President  of  the  Institution 
(Bislioj)  Bltmifid.n,  that  certain  nurses  from  St. 
John's  House  should  i)rocced  to  Scutari,  and  that 
he  should  himself  acecmipany  them,  "not  only 
to  be  their  j^uar.liaii,  but  also  to  act  as  ChapUiin 
jrenerallv  in  the  Hospital."  We  '\un\v  ]Kin 
of  the  correspondence: 

From  tlie  Bishop  of  Urtulon  to  tlic  Masicr  oj  St. 
John's   House 

rei-iiAM,  2.(ili  '  Vt..  1854. 

My  dear  Sir: 

I  quite  approve  of  both  parts  of  your  pro- 
posal, and  I  should  think  the  Cuuneil  would  also.  1 
have  written  to  Mr.  Sidney  Herbert  to  ascertain 
what  the  Government  will  do  in  the  matter. 

I  am,  yours  truly, 

C.  J.,  London. 

.  V(    f.,h„\  House  League  Sews,  Nov..  1003.  pp.  ia6-u7- 


Pre-Nicrlitii\i;alc  Times 


S7 


/.■,,.,«  the  Secretary  of   War  to  the  Bishop  of    London 

War  Office,  Oct.  17th,  1S54. 

My   r)KAR  Lord: 

Miss  Xij^htin^alc  has  consented  to  go  out  to 
Scutari  to  undertake  th<'  whole  manacjemcnt  of  the 
female  nursin-.  Her  Rreat  hospital  experience  and 
.kill  and  courage  in  surgical  treatment,  together 
^vith  her  administrative  capa.  iiy.  i^vuliarlv  fit  1h  r 
tor  this  undertaking,  and  in  a  Military  Hospital, 
where  subor<lination  is  cvervthing,  without  some 
recognised  head  with  amp'.  amh.Tuv,  then-  would 
he  no  chance  of  success.  She  is  in  communication 
with  the  Nurses  of  St.  John's  House,  and,  I  have  no 
'/luht,  will  take  them  with  her.  .  .  . 
Pray  believe  me,  yours  sincerely. 

SiDNi-v  TIkrhert. 


Letters  were  written  to  the  Times  an<l  subscriptions 
asked  for  the  "St.  John's  House  Fund  for  the  Si.  k 
and  Wounded  English  in  the  East,"  also  volunteers 
for  the  work,  who  were  to  be  trained  by  St.  Johns 
House  before  leaving  for  the  seat  of  war. 

After  various  negotiations  with  the  government  and 

Miss   Florence   Xightingale.  it   was  firallv   arranged 

that   St.    John's    House    should     furnish    a   certain 

number  of  its  nurses,  to  be  placed  un.ler  the  sole  and 

exclu.=.ive  charge  of  Miss  Nightingale,  and  to  proceed 

with   her  without  delay  to  the  East       .\t    a  meeting 

■f  the  Council  in  October,  1854.  the  Secretary  of  W  ar 

(Mr.  Sidney  Herbert^,  the  Chaplain-General  to  th" 

I- Tces.  ami    Miss  Nightingale  attended  at  St.  John's 

House  in  order  to  facilitate  arrangements.     It  was 

resolved  that  in  the  great  public  emergency  the  insti- 


88 


A  History  t)f  Nursing 


tution  \\nnlil,  at  considerablr  pecuniary  loss,  spare 
six  ■>!  its  mir-t  s  tn  prueet-d  tn  serve  under  Nliss 
Xiidiiin-^'ale  in  the  I'.ritish  hospitals  in  the  East, 
anil  that  th.e\-  sIimuM  lie  t'litireb.  umler  her  juris- 
dieti'Mi.  The  Mri^'inal  jil-ns  bein.u  thus  altered,  and 
the  W'^rk  heinur  ddUe  undt  r  (iuvernnient  instead  of 
bv  the  i!i-titutiiin,  tlie  services  of  the  Master  were 
ni't    rf(|uin'il. 

On  Oetobu-  .\;d  tlie  six  nurses  — Rebecca  I.aw- 
field,  ICniiiia  I'a.LZi;.  Ann  1  li.LTL'ins,  Klizabetli  Hrake, 
Mar',-  Ann  Covle,  Marv  Ai:n  H-urnett-  haviuj^'  re- 
ceived a  p,irtin>,'  c!i;irL,'e  and  benedictiun  from  their 
bishop,  started  for  Scutari,  and  were  accompanied 
by  the  Master  as  far  as  Paris.  The  Lady  Superin- 
tendent (Miss  Mary  Jones-  was  to  select  and  pri'j)are 
ailditMnal  nurses  t.'  f^U'W  this  first  detachment 
as  soon  as  ])ossibie.     Twenty  went  out  the  next  year. 

I'our,  alas'  out  of  the  first  j)arty  of  volunteers  re- 
turniMJ  -li-irily  \r>>m  Scutari,  u<>{  bein-  i>re].ared  t" 
be.ir  and  accept  the  discipline  and  privations  <A  the 
hie  nut  there.  The  remainder  ser\i'd  their  cfmntry 
with  ^^rcat  devotion,  as  the  following  entry  in  the 
Minute  Books  for  1855  testified: 

"The  Lady  Su])eri()r  has  also  received  an  anony- 
mous donation  uf  ^'loo  tor  the  Institution  from 
'A  Sister  of  an  Ollicer  Fallen  in  the  Crimea.'  The 
«lonor  also  wishes  this  sum  added  to  the  fund  for  the 
jmrposc  of  buildinj;  a  suitable  residence  for  St.  John's 
House,  and  expresses  a  hoi)e  that  the  House  may  be 
able  to  make  arrangements  for  takinj^  charge  of  the 
sick  in  King's  College  Hosiiital." 

Nurse  Elizabeth  Drake  died  of  fever  at  Balaclava, 
serving    at    her    imst    faithfully    to    the    last.     Miss 


Prc-Nightingalc  Times 


89 


Xi.uhlinpalc  writes  of  lur  in  the  hi.^'hest  terms,  sayin,L' 
in  a  letter  dated  August  I'l,  1S55:  "  I  lia\e  l<ist  in  her 
the  best  of  all  tlie  \V' imen  liere,  ...  I  fi'cl  hkt  a  eriiiii- 
nal  in  havinp;  robbed  you  uf  one  so  truly  to  be  loved 
and  honoured  It  seemed  as  if  it  pleased  God  to 
remove  from  the  work  those  \vho  have  been  most 
useful  til  it.  His  Will  be  dnni'!"  Miss  .\i,Lrlitiii,i:ale 
also  erected  a  small  marble  crnss  to  her  menK^ry  in 
the  cemetery  at  Scutari,  inscribed  with  her  name,  the 
date,  and  her  jimfession.' 

The  providing,'  of  nurses  for  tlu'  Criiiic;!  Mas  tlic 
indirect  cause  of  a  irrcat  expansion  ni  tlu>  ^vork 
111  St  John's  House,  for  tlie  necl  of  systematic 
trainint^  in  a  lios])ital  was  ihen  fully  and  widely 
acknowledL^ed.  It  now  also  became  c\"ident  that 
the  machinery  of  or.uanisation  was  unwieldy  and 
delayed  ])ro,i^ress,  as  tin  re  were  no  Uss  than  ti\e 
ditlerent  authorities  and  no  one  definitt'  Ik  ad. 
The  Master's  re])ort  of  1S55  instanceil  tb.e  slow 
;^'ro\vth  of  the  institute  as  a.  result  of  dixiijcd 
authority.  Tlie  Lady  Superior  explained  it  by 
the  want  of  a  sufficient  and  well-definni  field  of 
labour,  and  the  Ink  of  sullicicnt  hosjiital  facilities. 
So  far,  tltc  nurses  had  only  bet  11  '^oiui.,'  tor  a  few 
'ours  ilaily  to  learn  what  lhe\-  eoidd  under  the 
,iai(l  nurses  of  the  hospitals.  In  1X5,,,  -Miss 
Stanley  had  referred  to  their  results  in  the  fol- 
lowing words; 

There  has  been  great  comfort  afTordcd  to  the  ri(  h 

';'■-.■   nurses,   \na  hillicrt'i  the  orijjinal   promises 

'  >r  Jo'in's  House  I^'ague  Xeu's,  April,  1904,  pj).  i2t>  118. 


90 


A  Ilislon  of  NursiiiL; 


have  not  been  fulfilled.  Per  liuspilals  it  [the  insti- 
tution] has  not  provided  at  all;  for  families  insut'ti- 
cicntlv,  and  Tor  the  poor  very  imperfectly.  It  has 
so  far  trained  seventeen  nursi  s,  Imt  it  is  now  (greatly 
in  need  of  funds  and  without  eonsidcralde  aug- 
mentation of  its  funds  it  cannot  j,'o  on.' 

Al'init  this  time  ]iropositions  were  made  to 
St.  John's  House  'oy  KiiV-i's  College  hosintal, 
which  ha<l  been  founded  as  a  centre  for  leachin<,' 
as  well  as  for  the  rdief  "f  the  sick  poor, 

as  tf)  whether  an  arrant,'ement  eouid  be  entered  into 
bv  which  the  entire  nursini;  of  the  hosjiital  could  be 
undertaken  by  St.  John's  House.  Terms  of  agree- 
ment were  at  last  made  between  the  committees  of 
Kin.u's  College  Hospital  and  St.  J-hn's  Hou^e,  and 
on  March  ,:;  i ,  iS^'i,  the  Sisters  and  nurses  took 
over  the  work,  in  order  to  introduce  a  higher  class 
of  nurses  and  a  l)etter  system  of  nursing  into  the 
wards  of  the  hospital,  and  to  carry  out  more  fully 
than  hitherto  one  main  object  of  the  St.  John's  In- 
stitution- that  of  training  and  providing  nurses  for 
the  sick  in  hospitals  as  well  as  for  private  families 
and  the  |K>or. 

Manv  are  the  stories  told  of  the  day  the  Sisters 
took  possession:  nearly  all  the  old  staff,  who  resented 
the  change,  waited  bonneted  and  cloaked  in  the  hall 
for  their  arrival,  and  then  left  at  once,  leaving  them 
"to  fin<l  out  the  bail  cases  for  themselves";  and  by 
the  end  of  the  day  the  new-comers,  who  had  arrived 
in  clean  and  dainty  uniforms,  were  more  like  a  set 
of  sweeps  or  char-women,  in  such  an  appalling  state 

<  Hospitals  and  Sisterhoods,  p.  46. 


Prc-Nightiiv^alc  Times 


91 


I 


(if  (lisonler  had  tlifv  found  llicir  wards.  Very  soon 
a  niark('(l  inipro\cnvnt  bcRan,  and  \ve  find  the  com- 
mittee warmly  thankint;  the  Sisters  and  nurses  f(jr 
their  devotion  to  their  duties. ' 

.\  letter  in  the  Tinu'^  -  descrihcs  the  nrganisa- 
lion  and  system  of  the  new  ltMS])it;d  trainin*,^  frnjn 
the  time  of  its   foundation   in    1.S5O.     The  siati 
eonsisted    of    a  hidy  supericr,   Sislers,    a^;soeiate 
Sisters,     ladv     ivapils,    nurses,     assistant    nr.rses, 
probationers,  and  can(Hdates  on  tri:d.     The  Sis- 
ters were  huhesdl  refinement  whr)  i^aw  thi'ir  ser- 
vices ^rattiitously  and  Imre  t!ie  cost  of  tht  ir  own 
maintenanee.     They    entered    for    three    months' 
trial,    and     then     liecame    lad\-    ]i\i](ils,    assistant 
Sister,  nr  Sistei-.      The  ]irol)ationers  wore    usually 
of  the  ser\-ant  elass  and  w\'re  paid.     The   time 
of  ])roltation  was  three  months.     Thiy   liun  he- 
eame  assistant  nurses  for  nine  muntlis,  and  wen- 
thereafter    ealled    nurses.     The    time    of    traJTiin.i; 
one  year)   was  all  spent  in   ihe  hospital.     After 
that  the  nurses  were  emi)loye.i  in  hos])ital  or  in 
jirivate  duty.     St.  John's  House  took  char^;^e  of 
the  entire   household  department  of  Kins;'s  Col- 
U'i,'e  hospital,  the  kiteln  n.  tlu-  store-rooms,  linen- 
rooms,    and    laundrv;    il    retained    entire    control 
■.  er  all  the  nursing  staff,  and  by  its  contract  with 
he  hospital  the  directors  or  oUticcrs  of   the  latter 
ere  not  to  interfere  so  long  as  the  nursing  was 
.ell  done.      The  wards  were  thoroughly  staffed 

'  St.  John's  House  League  Xcws,  Oct.,  igo4.  p-  184. 
•  Fib.  M,  1874. 


92 


A  Ilistorv  of  Nursinc: 


and  tlic  work  was  faultlessly  done,  as  innumer- 
able witnesses  testified.  The  j^atients  were  un- 
(RtIv  nurs.'d,  their  siirroundini^s  kepi  extfuisitely 
elean  and  Drdrrlx',  and  an  atmosphere  of  refine- 
ment, sweet  cheerfulness,  ami  serenity  characterised 
the  wards.  Miss  Xit^htingale  once  said  ot  the 
nursin<^  thert'  that  it  was  the  most  "homelike" 
shr  had  ever  seen.' 

'riie  liduse  came  to  ha\e  traditions  of  p;ood  nurs- 
ini,' which  gave  it  an  atmosjiheie  greatly  cherished 
1)V  the  meml)crs.  The  jxitients  were  always  pvit 
before  e\-er\thing,  and  the  little  niceties  and  n- 
finemcnts  of  personal  care  were  steadily  impressed 
upon  the  pro! lationi'rs.  The  nurses  looked  lor- 
ward  to  sjtending  the  whole  of  their  nursing  days 
on  the  stalY,  and  \\ere  jealous  of  tlie  honour  and 
stamlards  of  the  house.  Many  of  them  sjjcnt 
twtntv,  twenty-five,  and  thirty  years  in  ])ri\ale 
lUirsin;.:,  and  tlieii  n-tind  on  a  ])ension.  Hut  the 
])resent  generation  is  less  statioruiry  and  may  re- 
eei\-e  a  larger  salary  in  lieu  of  the  ])ension. 

In  1861  the  Lady  Superintendent  expresses 
her  opinion,  in  the  Report,  of  the  desirability  for 
the  Cfnnpleteness  of  St.  John's  House  that  tlu' 
nurses  should  have  opportunity  for  training  in 
midwifery,  and  in  the  following  year  this  special 
braneli  of  work,  for  which  ever  since  St.  John's 
House  has  been  famed,  was  taken  up. 

In    1S74    a   struggle    took    place   between    the 

'  QuntiMl  liy  Lord  Hathcrly  in  a  letter  to  the  Tinw^,  ¥vh. 
aS.  1874. 


i 


rrc-Ni'ditiii'-alc  'limes 


93 


;i'lininistr;itive  authorities  of  the  liospital  ami 
St.  John's  Mouse,  which  was  written  u]>  freely 
ill  the  Times  of  that  year,'  and  in  the  Jhilisk 
'.L'Ucal    Journal  of  the  same  date.- 

The  contest,  which  was  in  brief  an  attempt  on 
ihe  side  of  the  hos])ital  nfticials  to  obtain  an 
^•^i^ressivc  and  u.i.'.dr  jx^Wfr  o\-L'r  the  nursinj.^ 
staff,  which  wrmld  have  im])airtMl  discipline  and 
dejjraded  the  standards  of  nursini:,  and,  on  the 
-•i  le  of  St.  John's  House,  to  defend  and  ])ri)U'et 
its  standards,  need  not  be  t'utered  into.  It  arose 
entirely  from  ii^noranee  of  what  ,^oMd  nursing 
work  was,  on  the  side  nf  certain"  hospital  nlli- 
eials.  It  is  of  interest,  howewr,  to  note  the  loyal 
supjwrt  .yiN'cii  to  the  House  b\  the  medie;il  staff 
of  the  hospital,  and  by  the  Mc^lioil  /■'itnial. 
The  latter  said  editorialK' ;  "One  thiiiL^  is 
abundantlv  t'vident,  and  that  is,  that  no  fault 
can  be  foiuid  ^vith  the  nianut  ,  in  which  the 
nursin,!,;  has  bt'cn  juTfonned." 

The  hospital  staff  spontaneously  remonstrated 
with  the  committee,  sa\ini:  :  "  Anv  chanj^v  which 
Would  remo\-e  the  nursing:;  from  the  care  ot  tlu' 
Sisters  of  St.  John's  House  is  j.;really  to  be  de- 
jirecateil  and  would  be  calamitous  to  the  hospital 
and  to  the  interests  of  the  jiatients." 

The  difficulty  was  fm;dly  adjusted  by  arbitra- 


I 


■'See  Times,  Feb.  14,  iS,  20,  28,  Apr.  27,  May  4.  '.S.  3'), 
June  19.   1S74. 

•  See  Journal  uf  1874,  pp.  208,  243  245,  283,  493,  591.  O54, 
fii.j,  59a. 


94 


A  History  of  Xursini^ 


linn  an'l  \hv  rcsi,L;n;ilioii  of  soiivj  "f  the  ollicials 
\vl)()  had  toinrntt'd  \hr  ln>nlilc',  and  St.  John's 
House  rcniaiiu' i  in  charLH'  of  thr  nursini^^  nntil 
1885,  ^vhc>!^,  under  an  entirely  frit-ndly  agreement, 
the  hospital   estabhsheil  its  own  training  school. 

St.  John's  House  also  carried  on  the  nursing 
for  the  Charing  Cross  Hospital,  from  1866  to 
1889,  of  t!ie  Mt-trop'4Itan  Hospital  frnm  18S8  to 
1896,  and  of  se\-eral  U'sser  hospitals.  In  188,:;,  as 
the  result  oi  nn  unf<  )rtunate  controversy,  a  serious 
schism  occurred,  and,  a  majority  of  the  Sisters 
having  separated  from  the  House,  the  Council 
calle<l  the  community  of  .Ml  Saints  to  take  charge 
of  its  ^vork.'  This  eoinuetion  lasted  for  ten  years, 
%vhen.  All  Saints  haxdng  urgent  calls  I'rom  its 
foreign  missions,  it  withlrt'W  iVom  mu'di  ot  its 
English  Work,  and  the  i  immunity  of  St.  Peter 
assumed  the  managenn  nt  of  St.  John's  House, 
\vhieh    it    has    kept    ui'til    tlie    jiresetit    day. 

St.  John's  House  is  in  niaiiv  respfcts  one  of  the 
most  interesting  an^l  atlraeti\e  nursing  found;'.- 
tions  in  Englaini.  U  has  drawn  to  its  ser\-ice 
an  admirahlv  endowed  set  of  wonun,  and  has 
lieen  distinguished!  by  an  t'Xtreine  li^ 'erality  and 
intelligence  of  vic-w  in  social  (Questions.  As  a  re- 
fining factor  in  nursing  its  iniluence  is  hardly 
to   be   overestimated. 

As  we  are  now  attempting  only  an  outline  of  the 
early  history  I  if  the  Anglican  nursing  sisterhoods, 

'  The  speeding  Sisters  took  the  n.-ime  Xursir^  Sisters  of  St. 
Joh.i  the  I>ivine.  :iiiil  esiaMished  themselves  m  Lewisham. 


Ni      I,, hi/-   ll.iM..-    1  hiHiM;  ^  >iiu:iri-' 


I 


l'rc-Nii,diling:xlc  Times 


95 


ihe  im|;nrtanl  part  which  St.  John's  House  has 
taken  in  i-iKxlern  echiealinnal  ([urstinns,  and  its 
l)n)gressivc'  attitude  on  social  i)roblems  must  be 
left  for  later  consideration.' 

The  Sisterhood  of  All  Saints  is  jjeculiarly  en- 
titled to  the  interest  and  rei^'ard  of  An.erican 
nurses,  for  it  was  to  this  ccjUiniunity  that  Sister 
Helen,   who  or>,^anised  Bellevue  Traininj^  School, 

All  Saints  has  had  a  distinctive  nursini^  history. 
Its  first  Superior  was  Miss  Byron;  its  founder 
and  Chaplain  was  the  Rev.  Upton  Richards, 
Vicar  of  All  Saints,  Margaret  Street,  London.  Its 
existence  dates  from  185 1,  and  the  first  work  it 
undertook  for  the  care  of  the  sick  was  the  estab- 
lishment of  St.  T-dizabelh's  Home  for  Incurable  Wo- 
men au'l  Children,  in  Mortimer  Street.  From  this 
arose  the  more  detlnite  and  systematic  relation  to 
hospital  nursing  which  came  to  characterise  this 
order.  In  1857  the  community  underto'  ''  regular 
nursing  duties  in  University  College  hospital, 
several  wards  being  ])ut  entirely  under  its  care, 
and  so  successful  was  its  administration  that  in 
1862  the  entire  charge  of  the  whole  hospital  was 
given  to  the  Sist(.<rs.  This  relation  between  hos- 
pital and  eisterhood  continued  until  i8(j(),  when 
the  hospital  established  its  own  secular  school  of 
nursing.     Three  Sisters  held  in  turn,  during  the 


1  Wo  arc  indcl)ted  tn  Mis.  M.u^arci  Brcay.  lion.  Secretary 
of  the  Matrons'  Council  of  (ireat  Briiain  and  Irilami  fnr 
'     Mv  details  of  St.  John's  House  hi.itory. 


96 


A  History  of  Nursing' 


■\\-\vAv  linu",  over  thirty  years,  the  position  of 
Sistrr  in-C"'iiiif  in  the  hospit.il:  they  were  Sister 
Elizabeth,  Sisler  (iertruile  Anna,  and  Sister 
Cecilia. 

The  relation  Nvith  St.  John's  House,  which 
dated  from  iSS:;  and  continued  until  iS():;,  brou.^ht 
an  enlaru't'd  field  of  hospital  nursiri.i;  to  the  Cf)ni 
numitv  of  All  Saints — tlu'  Metropolitan  hospital, 
St.  Sa\-iour"s,  ami  the  Maternity  at  Battersea  all 
for  a  time  cornini,'  under  its  care.  Incrcasin.u; 
deinati' .  ■  fron;  forei,i:n  countries  led  the  community 
to  reHni|uish  mmw  of  its  lui.ulish  posts,  l)ut  it  still 
cares  for  a  lar.i^e  convalescent  hospita^  at  East- 
bourne for  men,  women,  ;md  children,  and  a 
children's  hos])ital  in  the  same  place  ^vhich  was 
built  in  memory  df  the  Mother  Foundress.  The 
Sisters  are  now  acti\-e  in  I'ombay.  where  nursinj:; 
is  a  iirominent  feature  of  the  branch  house.  Two 
or  three  hospitals  are  under  their  management 
there,  and  during  the  plague  of  1899  they  supplied 
the  nur-mg  in  eight  hospitals,  some  o^  which, 
hM\ve\-er.  Were  tem])orar\-  structures.' 

Another  s'stt'rhood  which  made  nursing  a 
special  interest,  and  still  does  so,  was  St. 
Margaret's,  fi'undL'd  ])y  the  Rev.  Dr.  Xeale  in 
1854.  A  rarely  fresh  and  media-val  fervour  seems 
to  ha\-e  characterised  this  little  community  under 
the  U'adership  of  Dr.  Xeale,  \\-ho  was  another  St. 
Francis,  jicxtic  and  artistic,  more  scholarly  also 
than  St.  Francis  probably  was.  Its  story  has 
1  From  private  sources. 


I'rc-Niijhtinc'alc  Times 


^)1 


■  : ,  !i  told  in  ;i  xvrx  vxv;!,ivX\\v^  and  unaffected  style 
l.v  one  of  till'  Sisters.' 

A  short  exi)eri'.'nce  of  hospital  w  irk  was  rei;arded 
as  suftieient  ]irv'paration  for  the  demands  made 
\\\)()\\  the  Sistrrs;  the\'  did  not  include  any  ]tri\ate 
work  anionic  the  rich  in  their  nursinsj;  ])lans,  hut 
devoted  themselves  to  the  ser\  iee  of  the  ])()or. 
Sincere  and  unselfish  devotion,  with  zeal  to  yvv- 
form  tlic  most  menial  duties  of  scrub! lin.L;  and 
eleanint^  in  their  ]iatirnts'  homes,  eonstitutc-d 
the  chief  outfit  in  the  nursin.u'  armour\-  of  the 
Sisters.  Dr.  Xeale's  idi'a  was  that  still  found 
t'l-dav  anion;.;  the  eler;.;\' — nursins;  was  not  re- 
.Uarded  as  a  S})eeialtv.  but  as  an  accessory  to 
u'cneral  mission  work.  The  Sisters  wtre  (jften 
^ent  to  remain  with  a  ]iatient.  "  If  a  Sister  was 
nursing  in  some  lonely  out-of-the  wa\'  hamlet  he 
d)r.  Xeale)  would  alwavs  lind  time  and  j.(o  to  see 
•KT  at  least  once  durin.i:  her  ]HTiod  f)f  Tuirsintr," 
*-uns  the  memoir  spoken  of.-  And  a  letter  written 
by  Dr.  Xeale  to  ;.n  ajiplicant,  fi.xint.:  ii-  day  for  her 
to  be  met  by  fn^v  of  the  band,  said,  "All  the  oth- 
ers [the  Sisters]  are  out  nursini;."  The  Sisters  went 
sometimes  to  onr,  sonirtimes  to  another  hospi- 
tal to  ,uain  their  experience.  Sectarian  animosity 
sometimes  made  it  hard  for  tlu'in  to  i^et  e\'t'n 
this  little  trainiriLT.  One  letter,  dated  Deeemlar 
i;„  1859,  said:     "Will    you  tell  A.  L.  that  if  she 


'  Memories  of   a   Sister  of  St.  Saviour's    Priory. 
.\.  R.  Mouhray  Co.,  n;o4. 
-■  I'agc  .^o. 

VOL.   IT.  — 7. 


LoikU 


98 


A  lliiLuiy  of  Nursing 


wants  to   .uo  to  the  hospital  she  must 


i('ii  ■:'(■ 


she  is  a  Sister,  for  Sister  Martlia  cannot  get  a<hiiis- 
sion  into  one  nn  account    ol    her  cross,   and    Dr. 


X 


eale  will  not  let  her  ijut  it  otT."  ' 


A  frightful  scene  of  superstitious  haired  \v;.s 
enacted  one  time  at  a  funeral  of  one  of  the  Sis- 
ters, when  mol)  hrutality  hurst  forth,  and  a  couj)lc 
of  the  Sisters  \\\Te  almost  torn  in  pieces  and 
liad  to  be  taken  under  escort  of  the  police  to  u 
])lace  of  safety. 

In  many  years'  work  in  Soho,  St.  («iles,  and 
Haggerston  the  Sisters,  in  S])ite  of  their  elementary 
training,  fearlessly  hraved  small-pox,  typhoid,  and 
cholera.  Several  of  thein  ne.ped  to  nurse  in  Miss 
Sellon's  temporary  hospital  in  Spitalfields,  she 
and  Dr.  Pusey  having  taken  a  large  warehouse  and 
fitted  it  up  for  the  pur])ose.  n-ceiving  there  men, 
women,  and  children.  Sisters  of  Holy  Trinity 
also  assistefl  there,  while,  in  true  media-\-al  fash- 
ion, the  Cowley  Brothers  under  Father  Grafton 
helped  in  the  men's  wards  and  in  the  kitchen. 

Small -pox  was  a  fre<iuent  scourge,  and  the 
Sisters  relate  a  ULnnber  of  inconceivably  pathetic 
instances  of  its  horrors:  one  story  tells  how  they 
themselves,  by  night,  carried  the  little  coffin  of  a 
child,  which  no  one  else  would  touch,  to  tht 
morgue;  and  another  of  four  children  in  one  bed. 
two  of  whom  Were  <lead  of  small-pox  and  two  liv- 
ing, but  all  in  so  much  the  same  state  that  tin 
undertaker  who  luul  come  to  remove   the   tlea>i 

'  .l/i>»ioriV.N  ('/  (J  Siilrr  oj  >•(.  Saiiottr'i  I'riory.  p.  ag. 


Prc-\iL;htini(alc  Times 


99 


I 


l.o.lies  lu'situt(''l,  when  tlie  li\inL,'  chiMrcn  cricil, 
Oh,  Mother,  .M'ithi>r,  ddii't  U-t  us  ;^'i)  loo." 
Ill  1S71  the  Sisters  were  so  ovcrwhehiied  with 
ealls  to  sinall-pox  patients  that  they  appealed  lor 
aid  in  tlie  Times  of  Feb.  20.  Besides  visiting,  four 
Sisters  worked  cortinuously  in  an  emers^ency  hos- 
tntal  for  small-pox  on  the  Hackney  Road.' 

In  later  years,  after  the  Jubilee   Xurses   were 

established  and  alnanehwas   placed   in   Nichols 

Square,  the  Sisters  wrote :   "I  low  we  ever  manas^ei  1 

to  help  our  por^r  sick  people  before  those  invaluable 

nurses  came  I  cannot  think.     We  did  the  little 

we  could  ourselves,  just  in  our  own  parisli,  l)ut  it 

was  but  a  tiny  drop  in  the  ocean  of  sickness  and 

misery.     Now  it  rejoices  the  heart  of  every  one  to 

see  the  brij^ht,  cheery,  kindly  face  of  the  nurse 

js'oing  about  on   her  errands  of   helpfulness  and 

aecom])lishinj^  on  a  very  large  scale,  with  trained 

skilfulness,  what  we  used   to  attempt  on  a  \-ery 

nail  scale  with  anxious  unskilfulness."  ' 

We  have  now  followed,  at  least  in  outline,  the 

rly  efforts  and  achievements  in  li^nglish  nursing 

■'irm.     It  is  clear  that,  admirable  as  was  the 

irit  animating  them,  high  as  were  the  ideals, 

•id  great  the  energy  and  courage  of  these  early 

formers  and  pioneers,  yet.  in<lisputably,   their 

irsing  organisations,  modelled  as  they  all  were, 

ore  or  less  consciously  and  of  set  design,  on  the 

Tins  of  the  past  (thus  Doing,  in  fact,  imitations, 

mories  of  a  Sister  of  St.  Saviour's  Priory,  p.  uj-i  24. 
•i  .  V-  304. 


lOO 


A  Ili-lory  of  Xur-ing 


or  survi\-als  oi  a  former  order  of  thin.i^s),  (lid  not 
eoiUain  wiihiii  thmist.  Kcs  the  in-inei])le  of  growth 


or  a<laptaiiiiii  to  m-w  soeial  lornis. 


S 


loeietv  was 


aliiiut  til  take  (111  a  lUAVjihasc  thi' industrial — a 
phase  unlovelx'  in  itself,  hnt  ln'X'Mnd  wluc'h  fairer 
domains  of  social  justice  mij^ht  he  descried;  medi- 
cine was  about  to  become  a  new  and  eommandini^ 
science:  l)ased  on  research  and  alliid  ^\ith  a  t,dori- 
ous  tiL^ure — sanitation,  that  had  well-ni.gh  disa])- 
juared  for  over  2000  years  fn>m  t'  j  earth — tin 
medical  art  was  nnw  ]ir(.i)arinL;  to  proclaim  the 
doctrines  of  i)rcvention  rather  than  the  assuage- 
ment of  disease.  F.ven  religion,  that  for  so  many 
centuries  had  deciikd  the  fonns  and  extent  ot  th( 
nurse's  ministrations,  \v:is  oi\  tlu'  e'e  nf  turniii; 
from  a  snlu  cont(,tii])lati(>n  of  the  next  world,  t^ 
this  one,  to  become  less  abstract  and  more  prac- 
tical. The  creative  energy  that  was  to  transform 
the  nursing  of  lilngland  ;md  of  a  now  continent 
was  even  then  ready  to  break  forth.  Miss  Xight- 
ingule  was  preparing,  not  to  imitate  the  forms  (  : 
the  past,  but  to  shape  a  new  order;  not  to  re])r()- 
duce  the  Sisters  of  Charity  or  the  deaconesses, 
but  to  re-create  the  ancient  work  of  nursing  on  ;. 
])lan  fitted  for  and  adapted  to  the  oncoming 
changes  of  the  future. 


k 


CHAPTER    ITT 


I 


MISS  XU.llTIXt.Al.i:    AM)  Till-    CRIMEAX    WAR 

FLOREXCH     XllHITlXi-iALl-:,     the     rcvtml 
foundress   of    mo.Urn   innnol   nursinK^     tlie 
luToitu-  of  the  Crimea  an.l  the  L,ah'''i".^'  '-^I'''"'^  '"  '-^ 
l  ihl;  series  of  ri'l'iirm^  in  niihtary  an>l  ei\il  h<is]iil,il 
uihninist ration  and  puhhc  hyj^iene,  was  born  ui 
^hly,  1820,  and  is  still  living-     Ht'i"  ('lii<-'t'  contrihn- 
tion  to  the  inheritance  of  the  raer  lias  I'een  that, 
besides  demonstratint,' in  action  the  full  ])(rfeetii>n 
(.f  the  allied  arts  of  nursin,<,^  and   sanitation,   she 
has  left  in  lu  r  wrilin.u's  a  philosophy,  as  it  were,  of 
■  ursin;,',  toi^ether  with  an  intellectual  dctnonstra- 
:Mn  of  the  seientitic  and  natuial  basis  of  hyj^nene 
nd  its  practical  application,  and  has  laid  down 
nee  and  for  all  their  essential  vinderixinK  princi- 
ples with  a  clarity,  a  logic,  an  originality,  and  a 
'epth  of  reflection  that  mark  the  genius  and  place 
aer  works  among  the  classics. 

A  complete  and  authoritati\e  history  of  Miss 
Xiuhtingale  is  naturally  not  to  be  expected  until 
-■",(■  or  some  authorised  membiT  "f  lur  f.iniily 
shall  decide  to  give  it  to  the  world.  All  through 
lur  long  life  she  has  shown    great  ntucnce  as 

101 


I02 


A  Ilistorv  i)f  Xursinu^ 


to  her  own  achievements.  an<l  lias  disi 


)la\-e(i  a  seli- 


her    deeds — ainounliiu' 


(letachimiil  as  j,'reat  as  iier 
e\'en  l^  an  axersioii  to  liein.L,^  wriuen  al)i»m.  I'ut 
public  services  as  distin.^uished  as  hers  C' )ul<l  unt 
1)<.'  left  untnld,  and  a  number  of  biographies, 
more  or  le.ss  fra;.,anentary,  and  bio.i^raphical 
c}iai)ters  in  histories  of  the  Crimean  \V.,r  have 
bren  \vritti,n  of  her.  It  is  indeed  doubtful 
whether  any  wom;in's  story  has  been  repeated 
oftener,  or  with  greater  homage,  admiration,  and 
gratitude.  Vet  every  one  of  the  existing  accounts 
of  Miss  Nightingale  '"  *  •  far  short  of  being  pro- 
portioned to  her  {il  i'l  the  s])here  of  social 
progress.  It  is  true  tha;  certain  chapters  in 
Crimean  War  histories  which  are  devoted  to  her 
work  ha\e  the  most  genuine  ring,  as  of  personal 
knowledge,  but  they  touch  only  that  one  epoch 
of  her  long  and  consistently  useful  life.  (_)f  the 
earlier  biographies'  aiming  at  a  general  account  of 
Miss  Nightingale,  it  is  not  evident  that  any  of 
the  writers  was  al)le  to  draw  from  sources  othiT 
than  the  daily  press  and  records  open  to  everyone, 
while  of  later  ones  it  may  be  assumed  that  they 
contain  only  second-hand  material,  rewritten  in 
a  new  setting.  Hence  it  has  been  inevitable  that 
.1  somewhat  con\entionali,sed  saintly  type,  not 
unlike  liiat  of  the  media>val  legends,  has  come  to 
be  accepted  as  the  orth(>l<ix  figure  of  Miss  Night- 
ingale, so  that  it  is  not  always  clear  how  much  of 
the  human  and  real  personality  of  this  great 
'See  biblioKrajjliy  in  appt-ndix. 


Miss  Nightingale  and  Crimean  War  103 

woman  is  shmvn.  This,  indeed,  tlii'  writers  heliexe, 
is  only  1"  I'e  f;iirly  estimated  by  a  close  and 
thorou5j;h  study  of  her  \vritin,i;s. 

Tlie   most   serious    and    ailequatc   accounts   <>f 
Miss  Nightingale's  army  nursing  work  have  been 
triven  Iw  men,  nota!)lv    by  Kinglake,  who  more 
than   any   other   recognised    and    delineated    ac- 
eiiratelv  the  intellectual  quality  of  her  achieve- 
ments in   the  Crinv/a;   but    few   indeed  arc  they 
who  rear]   Kinglakc  to-day.  and  his  graphic  and 
fascinating    portrayal    of    the    Lady-in-Chief    is 
hidden  in  the  oblivion  which  now  obscures  the 
(Vin.can  War.    Few  persons  have  wielded  influence 
■  )  extensive  as  her^.   and   no  other  h>is  had   so 
definite  and  weighty  a  slnre  in  shaping  and  advis- 
ing in  hospital   and    nursing  affairs;   and    yet  so 
quietly  and  unassumingly  has  this  influence  been 
exercised  from  her  invalid's  couch,  that  few  of  those 
directly  benefited  by  her  counsels  haw  known  their 
source.     Her  writings,  too,  containing  as  they  do 
incomparable  statements  of  principles,  enunciated 
with  consummate  mental  supremacy,  have,  un- 
fnrtunately,    l)een   largely   hidden   away    in    Blue 
B<ioks,  reports,  proceedings,   and  encyclopedias. 
With  the   exception   of  the  Notes  on   Xur.stufi; 
What  it  Is  and  What  it  is  Not,  which  finds  a  place 
in  all  well-select cfl  libraries,  they  arc  not  readily 
accessible  to  the  general  public,  and  arc  all  but 
unknown  to  the  younger  women  who  are  following 
the  nurse's  calling.     We  must  hope  that  some  day 
we  may  know  the  full  inner  history  of  her  long 


I04 


A  History  of  Nursing 


years  of  cxperit-nco  ami  <)l':,i.r\-ati()n  in  the  manv 
lu)S|)itals  nf  Europe;  of  her  t.^inin^  at  Kaisers- 
werth;  of  the  vast  mihtary  hospital  system  in  the 
Crimea  to  which  she  apphcd  her  controlliii.LT  mind 
and  liand;  of  her  confidential  repots,  communi- 
cations, sugt^cstions  to  I  lie  War  Oftice.  and  im- 
portant share  in  the  reorganisations  that  followed 
the  war:  of  those  early  davs  in  nursing  reform 
when  all  work  was  pioneer  work,  and  every  new 
step  an  experiment  and  a  reM'lution;  of  the  in- 
numeral  ile  ci  inferences,  the  unceasing  current  ot 
advice,  suggestion,  and  insinration.  that  llowed 
in  all  directions  from  her  sick-room. 

A  work  has  recently  aj-)peared'  whieh  contains 
certain  hitherto  unpublished  material  concern- 
ing the  Crimean  e])oeh.  l»ut  in  so  fragmentary 
a  form  that  it  adds  little  or  nothing  to  the 
already  existing  records  of  importance  that 
refer  to  that  period ;  moreover,  it  is  knit  in  a 
context  so  biassed  and  narrow,  and  interpreted  in 
a  spirit  so  small  and  acrimonious,  that  it  is  more 
calculated  to  mislead  than   to  enlighten. 

The  writers  realise  well  their  limitations  in 
being  unable  to  present  any  new  and  authoritative 
material  relating  to  Miss  Nightingale  and  her  life 
what  they  have  tried  to  do  is  to  gather  together 
those  records  and  bits  of  scattered  personal 
testimony  which  seem  the  most  valuable    and  t- 

I  SiJiuy  Hi-rbcrt,  Lord  Herbert  oj  Lea,  A  Memoir,  hy  I-oni 
Stanniore.  In  2  volutjn.'s.  John  Murniy,  London;  E  P. 
Dulton  &  Co.,  Xew  York,  1906. 


Miss  Ni''htin<'alc  aiul  Criiiuan  WVr  105 


interpret  them,  so  far  as  lies  in  their  imwor,  by 
virtue  of  ;i  common  caUing. 
A   i^'enerous   fate    seems   to    have    presiiled    at 
Xiirhtinijale's  birlh,   for  every  adx-anla;^^'  ot 


liss 


aniilv,  scjcial  position,   euUnre,   and   weahh  was 
hers.     Rut  most  grateful  must  her  followers  feel 
in  her  father,  whose  passion  for  education  so  far 
outran  the  standards  of  his  day  that  he  was  in- 
. 'afferent  to  sjxjrt— that  id"l  of  his  eontempdraries 
-and  cool  toward  1  val  eharities  and  alms-givini,'s, 
hut  ardent  in  his  support  of  schools  for  the  rural 
]x»pulation.     To  this  enlightened  father  we  owe 
it  that   Miss   Nightingale   was   educated   with   a 
brcadlh,  scope,  and  thoroughness  uneomnv  m  not 
(inlv  then,   hut  now.      Ihr  ni.'ther,   a   woman   of 
heautilul    an<l    gracious    personality,    herself    the 
daughter  of  a  notably  liberal  and  philanthropic 
father,  endowed  her  with  e\ery  kindly  and  gentle 
gift,  and  taught  her  social  accomiilishnients;  but 
her    father    trained    and     diseijjlined     her    mind, 
fortified  it  with  an  am])le  stock  of  (ireck  and  Latin, 
mathematics,  and  natural  science,  made  her  pro- 
ficient in  (ierman,  French,  and  Italian,  and  took 
her  through  ancient  and  modern  literature.     In 
the  delightful  Mauoirs  of  Caroline  Fox  is  found 
this  anecdote: 

June  i2tli  [1857!  Warrenton  Smythe  talked  with 
jsTcat  delight  of  Florence  Nightingale.  Long  ago, 
1  .  fnre  she  went  to  Kaiserswerth.  he  and  Sir  Henry 
(!■■  la  Heche  dined  at  her  father's  and  Florence 
XiL;luingalc  sat  between  them.     Slie  began  by  <lra\v- 


IdO 


A  I  IInIoia'  (»r  Xur--in''' 


ini;  Sir  Henry  out  on  geolo^'v  and  charmed  him  by 
the  boldness  and  breadth  of  her  views,  which  wrre 
not  common  then.  She  accidentaliy  proceeded  in tn 
rej;;ions  of  Latin  and  Greek  and  then  our  geologist 
had  tf)  get  out  of  it. 

She  was  fresh  from  Egypt  and  licgan  talking  with 
\V.  Smvthe  about  the  inscriptions,  etc.,  where  he 
thought  he  could  do  ]iretty  well;  but  when  she  began 
quoting  Lepsius,  which  she  had  been  studying  in  the 
original,  he  was  in  the  same  case  as  Sir  Henry. 

When  the  ladies  left  the  room,  the  latter  said  tn 
him,  "A  capital  young  lady  that,  if  she  hadn't  floored 
me  with  her  Latin  and  Greek. ' 

It  has  Ix'cn  said  of  her:  "The  pecuHarity  in  the 
case  of  hcrseh"  and  her  rdatix'c-  seems  to  he  their 
having  licen  rcareii  in  an  alm(Ksphero  <<\  sincerity 
and  freedom — of  realitw  in  fact — which  is  more 
(hfticult  to  obtain  than  might  l)e  thought."^ 

.Much  as  Miss  Nightingale  owed  to  her  family 
inheritance,  she  was  even  more  a  product  of  her 
times.  The  nineteenth,  nfic^n  called  the  woman's 
centurv,  was  one  of  tuie.xampled  richness  in 
strong  personalities,  insistent,  inciuiring  ininds. 
protest,  (hssent,  researcli,  discovery,  and  reform. 
The  span  of  Miss  Nightingale's  days  was  the  time 
of  Owen  and  Shaftesbury;  of  Huxley  and  Darwin; 
of  John  Stuart  Mill  (whom  she  ardently  admired  . 
Mrs.  Fry,  Harriet   Martineau,  Mrs.  Jameson  and 

'  Mcotoru'S  0}  ( >ii  Friends.  Extra  ts  from  the  Journal 
.^n.l  Letters  of  Caroline  Fox,  1883,  p.  3;,6.  By  pcnnission 
of  the  publishers,  J.  B.  Lippincott  Co.,  Philadelphia. 

2  Life  oj  Ftorciirr  Xii^htiitt^alr.  by  Ingleby  Scott,  in  XuUs 
on  Xitrsiiig.     William  drier,  Bu.itun,  1S60,  p.  i. 


Mi--^  XiirhtiiTj-alc  and  (Yinicau  War  i 


o: 


Louisa    T\\inin!-:,  Ovov^c    Eliot,    MarL,Mnl    FuIKt, 
and  tb.c  HnAvninj^s.    It  was  llu-  time  when  a  uhnle 
i,'alaxv  of  stron;^^  notal)lL'  womni  lit'^ran  workiiiL,'  !>  t 
causes,   reforms,   and  progress;  writing,    strixiriLj;, 
and    demanding    to  speak   for  emancipation  and 
iustice.     As  early  as    1816  an   article  written  by 
Catherine  Co] >l)e  had  api)eared  in  the  I\i]nphht.cr 
called  "On  tile  I)esir;il>ility  and   Uti!il\-  of  Ladies 
Visiting  the  Fetnale  Wards  of  ll(is])itals  and  Linv 
lie  Asylums."     It   was  a   dignified    appeal,    \ery 
;^entle,  unaggressi\-e.   and    tmiehing.     The    writer 
spiike  of  the  "deliate  still  at  issue  res])ecting  the 
■  '■'licial  appoint nieiit  of  females  to  \isit  theajiail- 
ments  of  those  of  their  own  sex;"  of  the  great 
rvil   of   political  aiijiointees  in   sueh   in.uitutions. 
She    touched    bravelv    on     the    jealousy   ot    men 
in  fearing  an    enlarged    inlluence   and   sphere  of 
activity    for   women,  hut   mentioned   two  institu- 
tions. York  Coun.tv  hospital  .in  1  a  lunatic  asylum. 
where  the  jiractiee  of  ha\iiig  female  \isitors  had 
heen    established,    the    former    in     18:4    and    the 
latter  in    181  ^     ^^dlilc    Miss  Nightingale  was  in- 
vestigating hospital  and  nursing  conditions,  ruling 
in  the  Crimea,  and   founding  St.  Tliomas's  Train- 
•ng  School  for  yirses,  Mary  Cari)enter  was  toiling 
n  Ragged  Schools.   Mrs.   Jameson  was  lecturing 
-n  the  "So^.ii   Employments  of    Women.'     ;md 
the    "Community   of    L.abour, "    and   urging    the 
opening  of  the  great  institutions  of  misery  and 
poverty  as  schools  for  the  training  of  kind-hearted, 
helpful  women,   whose  energy  was  then   wasted 


1 


io8 


A  History  of  Xursin^- 


fur  \\:\n\  nf  a  vocrili'in,  and  dcclarin.ij;  the  biltrr 
lU't'cl  (if  ihi-'  inmates  oi  hospitals,  prisons,  asyhmis, 
workhnusL'S,  and  ivfonnalin-ics,  in  all  (il  whii'h, 
vnidt-r  the  routine  inaehiiu'dike  control  of  nun, 
the  ])oor,  the  sick,  and  the  dclinciuent  were 
sutYerin_^f  for  the  care  of  compassi(jnate  and 
motherly  women. 

It    was    ihe    lime   of    tlie    establishment    of   the 
National  Association  for  the  Proinoiion  of  Social 
Science,  at  whose  meetinsj;s  some  of  Miss  Xightin- 
1,'ale's  epoch-makin.1,'  pajiers  which,   according  to 
Lord    llroui^diam,   were  the  most  important  ever 
presented    to   it,    were   read;  of  the   first    women 
pioneers   in   univi^rsity  edneati'in,   nK'(!ieine,    and 
the   sulTrai^e   movement,     jolm    Stuart    Mill    was 
writini,'    on    "Liberty"    and    tlu'    "Subjietion    <>( 
Women,"    and     a    littk'    later    ArnoM    Toynbre 
went  to  live  in  the  Last  Side  of  Lotidon.      Xo  less 
si.yniticant  for  the  future  of  nur>in,i,^  was  the  fact 
that,    contemporaneousl}'    with    the    woman    ^^h'• 
was  to  revolutionise  this  ancient  eallin,L,^  liwd  the 
scientist   who  was  to  herald   the  change  of  the 
whole  course  of  medicine.     Lister  was  studying 
in  the  medical  school  while  Miss  Xightingale  was 
training    herself    at    Kaiserswerlh.     Three    years 
after  the  declaration  of  peace  following  the  Cri- 
mean war,   when   Miss  Xightingale  had  laid  her 
])lans  for  St.  Thomas's  Training  School  and  all  was 
in  readiness    for  it  to  open.  Lister  ])ubli>hed  his 
Early    Statics    of    Inflammation;    and    in     1S75, 
as  one  hospital  after  another  was  adoplmg  the 


Miss  Ni":litiiV'alc  and  Crimean  War  109 


.irm 


markcf]    out 


tV     llK'     s 


kill 


c(i 


cm 


irollin*'  mill' 


Miss  Xiijliliiv- 


haiids    aii'l 
for  the  cari.' 


jiaticnts,   Lister  l)rou;^'hl 


oul 


his 


The 


emu 


■jitatii 


Ch 


anccs    whuh      inarkt-i: 


a 


new 


rjii ) 


fh  in  medicine  and  surgery 


W 


:ial  1  he  unii  in 


W  IS 
till 


science    with    skilled    nursins;    was    to    do    lor 

pit. 

es  (if  tin 


ils  can   he  rea 


lised  by  readiiiL,'  some  of  the 
]ia])ers  read   before  medical  meetin,us 


iust   be 


forr   lh.it    tinu' 


iidrnne 


rN'sii'i.  las  in 


s])itab 


R 


rlation    bclwei. 


■n    1  )ii)htheri; 


All 


eeei 


and 


Cireater 


('iani,'rene  and  Hospital  Pla.nue, 

Morlalitv  of  l'e\-ers  in  Hospitals  than  in  Homes  of 


tlu 


I 


iMir, 


Poison  Saturation 


ol    ( 


I'lials. 


■rn  nurses   know  vwn 


v\\  Were 


Nor,  in  fact,  ilo  many   ni' 
hy  name  the  seour<^es  ^vh 
t'l  the  attendants  in  hospitals  in  that 
Miss  Xisihtim/alc  mav   be  rcjjjardet! 


imihar  entities 


mo^it 


ini:  m  whom 


impressive  example  of  a  human  bi 
inherent  i^^enius  and  naitu-al  inclination  wrre 
allowed  the  fullest  di-vel  i]imrin  and  expression. 
In  her  the  true  nurse  seems  to  h.i\-e  been  born. 


.IS 


\\e 


11 


that    wav 


as    maile 
and 


11 


er    earlK'S 


tew 


.f 


Iter 


t    tastes    inclined 
bioijjra pliers    have 


couie 


nmitted  the  story  of  She]),  the  wounded 
(log.  It  is  said  that  when  she  was  a  very  younj,' 
•:'\t\  one  of  Pastor  I-diedner's  re])orts  fi'll  into  her 
Ir 


inds  and  made  a  ( 


leei)  imi)ression  on  her,  e\X'n 


nia 


,er  voeation  clear  to  he 


Julia  Ward 
Howe  has   <j(\wn   an    interest in.L,^   j^limpse   of  this 


king  h 


-;;r  vl 


Pastor  Flkdncr.    Winkworth,    London,  iS';;.    ]> 


i:b. 


1  10 


A  History  of  Xui^iiv.;' 


early  desire  to  stiuly  nursin.tr  in  the  year  1S44, 
when  she  and  Dr.  IIdwc  were  abroad.  Mi>-s 
XiKhtinL^'ale  was  tlien  Iwenly-I'our  years  old. 

Mrs.    Bracebridge.  in  spcakinij;   to   mc   <it    Florence 
Nightingale  as  a  young  person  like!}-  to  make  an  ex- 
ceptional  record,    told    mc    that   her   mother    rather 
feared    this,    and    would    have    preferre<l    the    usual 
conventional  life  for  her  daughter.     The  father  was 
a  pronounced   Liberal,   and   a   Unitarian.     Wlnle  we 
were  still   at   Atherstone,  we  received   an  uivitation 
to  pass  a  few  days  with  the  Nightingale  family  at 
Emblev,  and  betook  ourselves  thither.     We  fouml  a 
line    mansion    of     l-dizabethan    anhitccture,     and    ;'. 
cordial  recei)tion.     The  family  consisted  of  father  an<l 
mother  and   two  daughters,  both  born  during  their 
])arents'  residence  in  Italy,  and  respectively  christene  1 
Parthenc  i],e  and  hi-  ^enee,  one  having  first  seen  the  light 
in  the  citv  whose  name  she  bore,  the  other  in  Naples. 
Of  ihe  I,  '    Parthti'ope  was  the  elder;  sh-  ■  .'as  not 
handsome,     but     was     piqnautc     and      ente.caining 
Florence,  the  yoimger  sister,  was  rather  elegant  than 
beautiful;   she   was   tall   and    graceful   of   figure,   her 
countenance  moVnIe  and  expressive,  her  conversation 
most  interesting.     Having  heard  much  of  Dr.  Howe 
as  a  philanthropist,  she  resolved  to  consult  Inin  u])on  a 
matter  wdhch  she  already  had  at  heart.     She  accord 
ingly  requested  him  one  day  to  meet  her  on  the  follow- 
ing morning,  before  the  hour  of  the  family  breakfast. 
He  did  so,  and  she  opened  the  way  to  the  desired 
conference    by  saying,    "Dr.  Howe,   if   I  should  de- 
termine  to  study  nursing,  and  to  devote  my  life  to 
that    profession,  do  you  think  it  would  be  a  dreadful 
thing?" 


Mi^^  Xi''htinralc  aiul  Crimean  War  in 

c5  O 


'  Bv  no  means,"  re])lic  1  my  luislmnil,  "1  think 
that  it  would  be  a  very  ;,'o()(l  thint,^" 

So  miu'h  and  no  more  of  the  eonvcrsati'in  Dr. 
Hnwc  repeated  to  me.  We  soon  heard  that  Miss 
Florence  was  devotin.t;  herself  to  the  study  of  her 
lireililcction ;  and  when,  years  after  this  time,  the 
Crimean  War  broke  out,  we  were  amoni,'  the  few  wlio 
were  not  astonished  at  the  undertaking  which  made 
her  name  world-famous,  i 

A  similar  .ulinipsc,  hr.^^  of  an  occurrence  that 
happened  after  Miss  Xii^dttini^^ale  had  been  at 
Kaiserswerth,  is  t,nven  by  Dr.  ]-^lizabeth  Blackwxll, 
another  revered  fl5.,'ure  ammi.i,'  ])ioneer  wiinu-n, 
who  beeaine  well  ac<itiainted  with  Miss  Xi,L,ditni- 
.<,'ale.  She  speaks  of  her  as  a  y(nin;^f  huh'  at  home 
chafing  under  the  restrictions  that  crip])led  her 
active  enerir}-,  and.  recalls  the  many  hours  that 
they  spent  toi,^ether  \n  discussin.L:  the  prol.)lems 
of  the  present  and  the  hopes  of  the  future.  Of 
one  of  these  x'isits,  she  writes  in  a  letter  to  her 
sister,  A]inl    17,    1S51 : 

Walked  much  with,  bdorencc  in  the  dcH'dous  air 
...  at  Embley  Park.  As  we  walked  on  the  lawn  in 
fnmr  of  the  noble  drawini2:-room  she  said:  "Do  you 
know  what  I  ahva\-s  think  when  1  loMk  at  that  row 
of  windows?  I  tliink  huw  I  shuidl  turn  it  into  a 
hosyjital,  and  just  how  I  shuuld  pkn  e  tlie  beds.  "- 

'  Ki'miiiisrences  of  Julia  Ward  Hohv.  Houghton  &  Mitllin, 
Boston,  i()oo.    ])p.  137-1,^8. 

■Pioneer  Work  in  Opening  the  MeJiiral  Profession  to 
Women,  Dr.  Elizabeth  Blai.k\V''n.  Longmans,  Green,  &  Co., 
I.i'niiun,   i8g5.    p.   185 


1  12 


A  1  li^tor\-  oi  Xurr^inof 


Pnsscssin.cj  tl-"^  natural  ^nft,  no  one  ever  cultivated 
it  more  tlv  >roujj;hly  than  she.  Just  how  mueli 
time  she  spent  in  studyinj^  hospital  cnnditions  \vc 
do  not  know  exactly,  but  certainly  a  period  ot" 
several  years  was  deNoted  t*^  a  careful  and  system- 
atic examination  >  if  hospitals  in  lilns^dand. 
Sef)tland,  Ireland,  l-Vanee,  Bel^Mum,  Germany, 
and  Italy,  and  to  the  study  of  nursini,'  history, 
hi'fore  Miss  Xii,fhtin.L;alc  went  to  Kaiserwerth.  t^ 
lie  trained  as  a  nurse.  Her  own  words  arc  well 
Wdrth  reniemherin;.;: 

I  would  say  to  all  yoiinc:  ladies  who  are  called  to 
anv  ]iartiiular  vocation,  qualify  yourselves  for  it  as 
a  mm  does  for  his  work.  Don't  tiiink  you  can 
understand  it  otherwise.  Submit  yourselves  to  the 
rules  of  business  as  nicn  do,  by  which  alone  you 
can  make  fiod's  business  succeerl,  for  He  has  never 
said  that  He  will  j^ive  His  success  to  sketchy  and 
unfinished  work.' 

Another  time  she  \vrf)te: 

Three  fourths  of  the  whole  mischief  of  women 
lives  arises  from  their  cxceptinR  themselves  from  tl 
rules  (){  trainini,'  considered  needful  for  mcn.^ 

Miss  Xi,i,dUini,^de  went  to  Kaiserswerth  for 
three  months'-'  traininj,'  in  i84().  and  a;,Min  for  :' 
shortiT  time  (some  weeks),  Pastor  Fliedner  wrotr. 
in  1850.     Only  scanty  records  of  her  stay  ther 

'  From  an  article  on  Kaiserswerth 


'  I'roni  "  l'n;i.  "  introthirtion  to  MminruiU 


.1. 


F'' 


ahi  th  foiirt.  hy  hvr  sistir.      London,    iS.S^.ji.    xxxii. 

'  I^roin  anonyrnnxis  biogr:iphy  in  Xota  on   XurstHg,  etliti' 

I  Sf)o. 


Miss  Xightingalc  and  Crimean  War  113 


I 


Id  bu  found,  hut  personal  recollections  of  aL,'e(l 
.Si.>ters  ha\c  testified  to  the  disliniJiuished  ahilit>' 
(if  the  English  lady.  vSidney  Herbert,  who  was 
Liter  destined,  as  Secretary  at  War,  to  put  her  in 
charije  of  the  Crimean  military  hos])itals.  visited 
lnT  here  as  an  old  friend,  saw  her  at  work. 
,111' I  heard  the  encomiums  of  the  Fliedners  upon 
lur  work.  Of  Kaiserswerth,  Miss  Xii^htin;j;ale  said 
■"'.rward^: 

!  was  twiec  in  trainin,t,'  ihcre  myself.  Of  course, 
I'  tlien   hospital  and  dislriet  nursing'  have  made 

,1'  strides — indeed,  district  nursing  has  been  in- 
\ tilted:  but  never  have  I  met  with  a  higher  tone,  a 
purer  devotion,  ilian  there.  There  was  no  neglect. 
It  was  the  more  remarkable  l)ecause  many  of  the 
I'eacone.'^ses  had  been  only  peasants;  none  were 
trtntlewomen  when  I  was  there.  The  food  was  pcjor. 
X  '  luxury  but  cleanliness.' 

She  next  spent  some  time  \\ith  the  Sisters  of 

S*.   Vincent   de   Paul  in    Paris,  studyin}.^   French 

AJiich  was  famous,   and   the  admirable 

thod  of  institutional  atlministration  and  man- 

ment  of  the  Sisters.       It  was  his   knowledge 

"i  iier  lonjj,  ri,u;orous,  and  adequate  training:;,  and  of 

•!if  executive  ability  she  had  shown  later  in  brinj;- 

"rder  out  f)f  chaos  in  the  Ilarley  St.  Home  for 

'overnesses,  as  .veil  as  personal  admiration 

her  as  an  old  and  intimate  friend,  that  prompted 

m-v    Herlx-rt,    vhen  the   storm  of  war  broke 

''•■  Rast,  ;n(I  the  appallinjj;  break-down  in  the 

'In    a   IcttiT   liri'<i'rv-fri    in    t]ii'    I^riti\*l    \t.l<<'ittn 


114  A  Ilihtory  of  Nursin;^' 


hospital  service  became  known,  to  write  to  lur 
from  the  War  Ollice  urj^inj^  her  to  ^^o  to  the  rescue, 
with  the  wopIs:  "There  is  but  one  jXTSon  in 
Enj^land  that  I  know  of  who  woukl  be  capable  <■'" 
orjjanising  sueh  a  scheme." 

The  Crimean  War  had  broken  out  in  Marcli, 
1854,  and  with  the  news  of  the  first  battles  had 
come  grievous  accounts  of  neglect  and  misman- 
agement in  the  me<lical  department;  RusseH, 
the  special  correspondent  of  the  Times,  wrote  on 
vSept.  26,  1854: 

It  is  with  feelings  of  surprise  and  anger  that  tlic 
public  will  learn  tiiat  no  sufficient  preparations  have 
been  made  for  the  woundeil.  Xot  only  are  there  n^t 
sutlieient  surgeons — that,  it  might  be  urged,  was 
unavoidable;  not  only  are  there  no  dressers  and  nurses 
— that  might  be  a  defect  of  system  for  which  no  one 
is  to  blame;  but  what  will  be  said  when  it  is  known 
that  there  is  not  even  linen  to  make  bandages  fnr 
the  wounded — after  the  troops  have  been  six  months 
in  the  tountry.  there  is  no  preparation  for  the  com- 
monest surgical  operation?  Not  only  are  the  men 
kcjjt,  in  some  cases,  for  a  week  without  the  hand  nf 
a  medical  man  coming  near  their  wounds;  not  only 
are  they  left  to  expire  in  agony,  unhccdeil  and  shaken 
oil",  though  catching  desj)erately  at  the  surgeon 
whenever  he  makes  his  rounds  tlirougli  the  fetil 
ship,  I)ut  now,  wlun  they  are  jilaccd  in  this  spacious 
buililing  [the  Barrack  Hospital  at  Scutari],  it  is 
found  that  the  commonest  api)liances  of  a  British 
workhouse  sick  wanls  are  wanting.' 

'  Thf    '/'I'lll.v,   Oct      I  2.    lS;4. 


Mi^^i  Ni;>;htingalc  and  Crimean  War  i  15 


Two  (lays  later  hv  wrote 

It  is  impossible  for  any  one  to  see  the  melancholy 
:'h{?,  of  the  last  few  ilays  without  feelinj^s  of  surprise 
.,!i(i  inili^nation  at  the  deficiencies  of  our  medical 
svstem.  The  manner  in  which  the  sick  and  wounded 
have  been  treated  is  worthy  only  of  the  savages  of 
Dahomey.  Numbers  arrived  at  Scutari  without 
having  been  touched  by  a  surgeon  since  they  fell, 
pierced  by  Russian  bullets,  on  the  slopes  of  Alma. 
The  ship  was  literally  covered  with  prostrate  forms, 
s'l  as  to  be  almost  unmanageable.  The  officers  could 
IV  it  get  below  to  find  their  sextants,  and  the  run  w-as 
made  at  hazards. 

The  worst  cases  were  placed  on  the  upper  deck, 

whirh,  in  a  ilay  or  two,  became  a  mass  of  putridity. 

The  neglected  gunshot  wounds  bred  maggots,  which 

iwled  in  every  direction,  infecting  the  footl  of  the 

•ihappv     beings     on     board.     The     putrid     animal 

latter  caused  such  a  stench  that    the   officers   and 

\'\v  were  nearly  overcome,  and  the  captain  is  now 

1  from  the  effects  of  the  five  days  o*^   -lisery.     All  the 

Sankcts,  to  tlic  number  of  1500,  have  been  thrown 

.orboard  as  useless.     There  arc  no  dressers  or  nurses 

.  .  Their  [the    French]    medical   arrangements  are 

Ktroinely  good  .  .  .  they  have  also  the  help  of  the 

-^isters  of  Charity'  who  have  accompanied  the  expe- 

ition    in    incredible    numbers.     We    have    nothing. 

;'c  men  must  attenil   to  cac  li  other  or  receive  no 

relief  at  all.^ 

'  The    Russi.in   soldiers  were   also   attended   by   Sisters  of 
M  •  V      Mme.  B;ikounina.  their  head,  was  called  the  Russian 
:mro  NiRhtjnRalc.     She  and  her  staff  used  to  go  out  in 
Ik;  IfKits,  and  carry  in  the  wgun  led. 
'  Ti»h!>,  Oct,  13,  1854. 


I  10 


llislory  of  Xur.^inL; 


Shortly  l)cforc'  he  had  wriUcn: 

The  sick  aj)pi;arc(l  to  be  altemlcd  by  ilie  sick,  and 
the  (!yin,t,'  by  the  dyins;. 

Indignation  and  jjity  swept  throu;,di  Enfrland, 
and  the  papers  were  full  of  Utters  and  ealls  for 
assistance.  A  ringinj:;  api>eal  for  nurses,  sijj;ned 
by  "  Medicus,  "  in  the  Times, '  said  :  "  Why  are  there 
no  female  nurses?  Away  with  this  nonsense 
[rules  of  ser\ieej'  iIktc  ;;;;(.s7  be  female  nurses." 
This  demand  was  echoed  f»n  all  sides,  and  whni 
Russell's  im])assioned  aj^peal  to  the  Wdmen  of 
lCn}j[land  was  read,  military  red  tape  was  swept 
away  in  an  outburst  of  public  emotion. 

Are  there  nr)  devote*!  women  amons;  us  [lie  cricdl. 
able  and  willinjj;  to  ^'o  forth  and  minister  to  the  sick 
and  suffering  soldiers  of  the  Kast  in  the  hospitals 
at  Seutari?  Are  none  of  the  dauj,diters  of  Er  Jand, 
at  this  extreme  hour  of  need,  ready  for  such  a  work 
of  merey?  Franee  has  sent  forth  her  Sisters 
Merey  unsparini;ly.  and  they  arc  even  now  l)y  the 
bedsides  of  the  wounded  and  the  dyini(.  ^,'ivini;  what 
woman's  liand  alone  can  j,'ive  of  e<rmfort  and  relief 
in  sueh  awful  scenes  of  sulTerini,'.  Our  soldiers  have 
foiitjht  beside  the  troops  of  Franec,  certainly  with  no 
inferior  eouraj^e  and  devoteilnet,s,  in  one  of  the  inost 
sanjj[uinary  and  terrific  battles  ever  recorded.  Must 
we  fall  so  far  below  the  1-Vench  in  self-sacrifice  ami 
<levotedncss  in  a  work  which  Christ  so  sijjnally 
blesses  as  done  unto  himself' — "T  was  sick,  and  '•■'■• 
visited  Me"?^ 

'  TiiiUi.  I  ><.t    14. 


Mi^s  Ni-lilinL;'alc  diul  Lrimcan  War  117 

The    response    was    instantaneDUs.     The    <il!rr 
nia<le  liv  St.  J<'hn's    House  has  been  nienlitnied. 
Tlie  Cat.holic  Inshop  ot  Soulhwark  olYereil  to  send 
Sisters;    there     were     volunteers     from     mecHeal 
students  and,  as  in  later  wars,  enthusiastic  but 
undisciplined    society    women    dehr^ed    the    War 
( liliee  with  ajiplications.     The  liisl  jiractical  steps 
.111  to  have  I)een  taken  by  Lady  Maria  Forrester, 
K>  daughter  of  an  Irish  nobleman,  who  engaged 
iiree  nurses,  ])romise(l  to  pay  their  ex])enses,  and 
4;.'d  .Miss  Nightingale,  on  the   nth  of  October, 
•    she   would   take   them   to    tlie   Crimea.     Miss 
Nightingale    consented,    and    wrote    her    historic 
kiter  asking  if   Mr.    IkTbert,   then  Secretary  at 
War,  would  endorse  and  authorise  their  going.' 
.-he  also  asked  Mrs.  Herbert  (her  i)er.sonal  friend) 
tu  send  word  to  Lady  Stratford,  the  wife  of  the 
I'.rilish  Ambassador  at  Constantinf)i)le,  that  Miss 
Xightingalc  was  not  just  a  lady.  Init  Aas  a  hospital 
nurse  with  experience. - 

The  coincidence  of  this  letter  crossing  one  from 
Mr.  Herbert,  begging  her  to  go  to  the  Crimea,  is 
Well  known.  Hi-  olTcred  her  the  .support  and 
backing  of  the  government,  and  assured  her  that 
she  alone  was  capable  of  saving  the  situation, 
saying: 

W-nild   yrm   listen    to   tlir   v,.,n)c<t    tn   "o   dut    ami 

'  /•.i1n/,ti(  //os-pi/ii/s  aui  luti^ltsii  .Xirr."..  i>y  .i  L.kIv  Voluii- 
t(<r     Hurst  *  Hl.irkitt,  l^omlon,  185O.  and  edition,  vol.  i., 


ilU'lti     I',      .-l:ii 


Hirhrrt,  \i<\ 


ii8 


A  History  of  Xursinif 


supervise  the  whole  thing'  Upon  ynur  derision 
will  (kpcnil  the  ultimate  success  or  failure  of  the  plan. 
Your  own  personal  qualities,  your  knowledge,  your 
power  of  administration,  and  among  greater  things 
your  rank  and  position  in  soriety  give  you  advantag'  ^ 
in  suiii  a  work  which  no  other  j)erson  possesses.' 

One  week  after  tliat  time  Miss  Nightingale  had 
her  group  of  nurses  ready  to  start.  She  gives  the 
list  as  follows:  lo  Roman  Catholic  nuns,  of  two 
(lit'ferent  orders,  one  cloistered,  one  not;  8  Sisters 
cjf  Mercy  of  the  Church  of  England,  of  two  dif- 
ferent houses;  6  nurses  from  St.  Juliii's  Institute; 
14  nurses  actually  serving  in  different  hospitals. 
Mrs.  Bracebridge,  who  umlerttjok  the  domestic 
management;  Miss  Nightingale,  superintendent.^ 
Some  of  the  Anglican  Sisters  came  from  Miss 
Sellon's  sisterhood.' 

The  first  place  to  which  Miss  Nightingale 
turned  to  look  for  nurses  was  the  institute  founded 
by  Mrs.  Fry, — but  the  spirit  of  Mrs.  Fry  must  have 
been  for  the  time  being  absent,  for  the  directors 
Were  not  willing  to  accede  to  the  very  necessary 

'  PincotTs  says  that  this  lotter,  which  appeared  in  tl.' 
Daily  Xcws  of  Oct.  asth,  was  given  out  by  an  indiscrti ' 
friend.  See  Experience  of  a  Civilian  in  Eastern  Military 
Hospitals.  Peter  PincofTs,  M.D.  Williams  &  Nori^ate,  Lon- 
don, 1857.  p.  73.  Pollard  gives  it  in  full.  See  Floreih 
Nightingale,  by  Eliza  F.  Pollard.  S.  W.  Partridge  Co.,  Londui;, 
iyo2.     pp.    74-78. 

'  In  \otes  on  the  British  Army.  p.  154- 

»  The  Times  of  Oci.  30  iiicntiuns  a  Miss  I'-rskine,  daught^ 
of  a  Welsh  nobleman  as  a  "certificated  nurse"  who  had  goi 
with  Miss  Nightingale. 


Miss  Ni'jluiiV'alc  and  (  rinicaii  War  119 

riindition  that  tlir  nurses  should  be  solch'  under 
Miss  .\i,L,ditin.L,'al(j's  authority,  and,  for  the  time 
beinij,  removed  from  that  of  their  own  liome  es- 
tabHshment.  St.  John's  Hou:e  had  at  hrst  also 
ohjected  to  this,  but  tlien  waived  their  objection. 
Miss  Nightingale  left  England  for  the  Crimea  on 
October  21,  1854,  arriving  there  on  Xov.  4,  and 
remained  there  for  nearly  two  years,  or  until 
August  8,  iS^(),  the  date  of  her  return  to 
England. 

Grateful  recognition  must  ever  be  given  to 
Sidney  Herbert,  for  the  daring  and  firmness  with 
which  he  carried  out  the  then  unheard-of  experi- 
ment of  introducing  gentlewomen  as  nurses  into 
the  military  hospitals.     Kinglake  says : 

lie  -luietly  yet  boldly  stepped  out  beyond  his  set 
liounds,  and  not  only  became  in  this  hospital  business 
the  vdluntcer  delegate  of  the  Duke  of  Newcastle, 
but  even  ventured  to  ai  l  without  always  asking  the 
overworked  department  of  war  to  go  through  the 
form  n{  supporting  him  by  order  from  the  Secretary 
of  State  ' 

The  ofiicial  position  which  the  gf)vernment  had 
given  Miss  Nightingale  was  Superintendent  of 
the  Nursing  StatT  in  the  East,  and  the  title  by 
which  she  eventually  became  known  was  that  of 
the"Lady-in-Chief." 

.\  little  book  of  somewhat   ouestinnable  relia- 


'  he  Invasion  of  the  Crimea,  i8So,  vol,  vi.,  chapter  xi  ,  j). 


!  20 


A   IlistoiA'  of  Xui'siii!^" 


liilit)  '  (juotc's  from  the  iviort  issucil  liy  Miss 
XiLjhUnLralc  aflcr  iIk-  \v:ii  to  ihc  tlmiors  (if 
\-iihnnary  subscriptions,  tliiis:  that  hrr  "supcrin. 
tendciice  cxtcndcil  over  the  fcmali-  iiursin,i( 
cstabHshmcnt  of  tlio  liarrack  and  General  hos- 
pitals at  Scutari,  of  those  at  Koulalee,  and  of 
five  general  hospitals  in  the  (Vimea."  It  seems 
])rohal)le,  from  Sidne\-  !  Krlicrt's  letters  that  her 
super\"ision  of  the  last-mentioned  hospitals  was, 
at  first,  more  like  that  of  a  sanitary  chief  or 
general  director,  and  not  directly  that  of  an  or- 
ganiser of  nursing,  although  her  authority  as 
nursing  he  id  was  finally  recognised  in  all. 

The  first  and  chief  sct'tie  of  her  labours  was 
the  great  Barrack  hospital  at  Scutari,  which 
hai!  been  lent  to  the  British  Government  by 
the  Turks.  It  is  an  enormous  sciuare  building, 
three  stories  high  and  whose  corridors  ha\x  a 
total  length  of  Nun"  niilrs.  and  is  now  restore<l  to 
its  original  use  as  a  military  barrack.  Tlie  'J'iiurs 
correspondent  wrote  of  her  arri\ing  with  her 
ladies,  all  dressed  quietlv  in  black,  and  of  the  hope 
inspired  by  the  sight  in  those  who  walehcd  them 
wend  tli.eir  w;iv  up  fn  ini  the  shnre.  The  con- 
ditions in  and  around  the  hos])ital  were  such  as 
to  defy  descrijition,  though  Russell,  perhajis 
sunieuhat    chastened     by    the    military    officials, 


'  Aulohioi^raphy  of  a  !}alarla:'u  Xitrsc.  by  Mrs.  Eli/,aln'th 
Davis,  a  vols.,  Lomloii,  1857.  (Jui-sliunablc  btcausf  the 
writer  w:is  an  illiterate  and  ef^otistical  person  of  narrow  in- 
telligence, one  of  the  paid  nurses,  who  h.nl  been  a  co(/k. 


iii'    Aiiicrlc.tii  j.iunial  ul"  Nursing; 

Tiic  Barrack  Hospital  at  Scutari 


Miss  Nightingale  and  Crimean  War  121 


now  wrote  rather  whitewashing  letters,  sayin- 
that  the  men  were  "not  uncomfortable"  and  thr 
wards  were  "clean. '"'  But  after  the  battle  of 
Alnia  the  w.iuni'.eil  had  poured  into  the  hospital, 
their  wounds  still  undressed,  their  fractures  not 
Set,  and  they  were  half  starved.     It  was  said  that 

There  were  no  vessels  for  water,  or  utensils  of  any 
kind;  no  soap,  towels,  or  hospital  clothes;  the  men 
lyin^f  in  tlieir  uniforms,  still  with  ,L,'ore  and  covered 
with  tilth  to  a  (let,'ree  and  of  a  kind  no  one  eould 
write  about:  their  persons  covered  with  vermin, 
whieh  crawled  about  the  floors  and  walls  of 
the  dreadful  den  of  dirt,  pestilente,  and  death  to 
which  they  were  consi,;,nied.  The  medical  men  toiled 
with  unwearied  assiduity,  but  their  numbers  were 
inadequate. 

This  was  tlie  scene  on  which  .Miss  X\^;htin:^Mlt' 
entered,  and,  at  the  very  tirne  of  her  arriwil, 
the  wounded  were  a,L:ain  ])ourin,i,r  into  the  hospital 
by  the  hundred.  The  Rev.  Sydney  Osborne  has 
left  a  graphic  account  of  the  cf)nditions  with 
which  Miss  Xi,i:;htingale  had  to  grapple  on  her 
arrival  and  n(  the  colossal  indifference  of  the 
military'  oilicials: 

I  arrived  at  Constantinople  on  the  cicrhth  of 
Xnvcmber:  on  tliat  or  the  f<j!!f)wing  day  we  heard  of 
the  battle  of  Inkerman,  a  transport  ship  having' 
;irrivcd  with  a  lari^'e  number  of  the  wounded.  The 
same  day  that  I  arrived,  I  crossed  the  Bosphorus  to 
Scutari,  and  went  to  the  general  hospital,  and  there 
presented  a  letter  from  Mr.  Herbert  to  the  superior 

'  Tlw  Times,  Now  i8  and  23,  1854. 


I  22 


A  i  li^tors'  of  Xursiii 


.-1 


medical  officer,  Dr.  Mnizifs;  he  took  me  nnmcl  some 
of  the  wards  of  lluil  luuMiiiL;,  ami  to  my  repealcil 
otters,  either  from  my  own  or  other  funds,  of  as- 
sistance in  any  way  in  which  it  could  be  aflorded  I 
received  the  answer  "they  had  everythin^^ — nothinj,' 
was  wanted."  ...  I  was  not  for  one  moment 
deceived  by  the  declaration  of  Dr.  Menzies  that 
nothing  was  wanted;  i  have  had,  as  my  friends  all 
know,  for  many  years  an  intimate  acqnaintame 
with  most  matters  rclatini,^  to  medical  and  surgical 
practice;  I  think  I  can  say  with  truth  I  have  followed 
the  study  of  meditine  and  surgery  for  twenty  years 
of  my  life,  with  an  attention  equal  to  that  of  many 
who  do  so  as  a  matter  of  professional  dut\- — a  hospital 
and  its  requirements  were  no  new  thing  to  me. 

It  would  only  tire  the  general  reader  if  I  were  to 
go,  day  by  day,  into  the  oc  rrences  which,  following 
in  quick  succession,  soon  proved  to  mc,  not  only  that 
these  vast  hospitals  were  absolutely  without  the 
commonest  provision  for  the  exigencies  they  had  to 
meet,  but  that  tliere  was  in  and  aboiit  the  whole 
sphere  of  action  an  utter  want  of  that  accord  amongst 
the  authorities  in  each  department,  which  alone 
could  !::e:ure  any  really  vigorous  cflort  to  meet  the 
demands  which  the  carrying  on  of  the  war  was  sure 
to  make  upon  them.  It  is  quite  true  that,  as  ship 
after  ship  brought  down  their  respective  cargoes  of 
wounded  and  sick,  the  medical  and  other  officers, 
with  Miss  Nightingale  and  her  corps  of  nurses,  did 
work  from  morning  till  night  ami  through  the  night, 
in  trying  to  meet  the  pressure  upon  tlulr  scanty 
resources;  but  the  whole  thing  was  a  mere  matter  of 
excited,  almost  frenzied  energy,  for  where  so  much 
that  was  necessarv  was  absent    it    folhjwed    that  all 


Miss  Nightini^^alc  and  Crimean  War  123 


t!iat  zeal  ami  labour  could  eflcrt  was,  bv  various 
temporary  expedients,  to  do  that  whit  h  whtn  dc^ne 
was  wholly  inadequate  to  what  was  really  required. 
I  saw  all  the  Balaclava  and  Inkerman  wounded  had 
to  .u'o  through;  I  had  it  from  the  lii)s  of  the  chief 
ai  tors  in  the  scene  what  the  preparations  were 
\v:iich  awaited  the  wounded  of  "Alma."  1  know 
whac  the  chaplain  and  otTicers  had  to  do  then;  the 
"Sisters"  had  not  arrived — there  was  no  Miss  Xii^ht- 
in,L,'ale  with  that  wonderful  power  to  command  help, 
the  quickness  to  see  where  it  would  most  a\ail.  I 
can  say  with  truth  I  am  .c:!ad  I  have  not  that  tale  to 
tell.  And  yet  I  could  not  find  that  anything;  had  been 
asked  from  Lord  Redcliffe  even  up  to  the  time  I  saw 
the  hos])ital  myself.  Why  should  he  have  been  asked 
fur  help?  The  chief  authority  was  clearly  under  the 
delusion  that  "nothint^  was  wanted."  ...  I  jiave 
never  seen  any  accounts  yet  that  have  in  tlieir  united 
inf(jnnation  really  ^dven  the  whole  truth  as  it  mi^ht 
he  i,'iven.  I  cannot  conceive,  as  I  now  calmly  look 
back  on  the  first  three  weeks  after  the  arrival  of  the 
wounded  from  Inkerman,  liow  it  could  have  been 
possible  to  have  avoided  a  state  of  thins,'s  too  dis- 
astrous to  contemplate  had  not  Miss  Nii,'htin>^ale 
been  there,  and  had  the  means  placed  at  her  disposal 
by  Mr.  Ma  donald  [a  special  commissioner  sent  with 
!ar«;e  funds  by  tlie  Tinics.]  I  could  enumerate 
tiirouirh  a  very  long  list  article  after  article  of  absolute 
necessity,  as  a  part  of  hospital  stores,  which  was 
enher  not  in  existence,  or  so  stored  as  to  defy  access 
to  it.  It  was  not  merely  that  with  t!ie  exception  of 
a  -Aard  here  and  there  there  was  no  appearance  of  the 
(inler  which  one  would  have  expected  in  a  military 
'Hospital,  supported   at   an   almost   fabulous  expense; 


1-4 


A  IIist(M"v  of  Nursinsj;" 


lull  there  was  an  utter  absence  nf  Jie  commonest 
preparation,  lo  carry  out  tlie  very  first  ami  simplest 
(iemanils  iii  a  ]ikue  set  ajtart  to  recii\«  the  siek  and 
woundeil  of  a  lar<j;e  army.  ...  1  here  ileliberatelv 
record  my  conviction  that  not  only  was  tlie  Ilonie 
Government  .grossly  deceived  Ity  the  inl'Mrmati^n  it 
received  from  the  East,  hut  that  it  must  have  been 
most  j:r''<>ssly  betrayed  at  home  by  those  to  whose 
several  dcpavtments  the  projjer  manai,'ement  of  the 
details  of  those  hos])itals  was  entrusted.  Had  .Miss 
Xi^ditintjale  and  her  stall  taken  up  their  post  in  the 
liesl  retjulate  1  hospital  conceivable,  with  four  thousand 
patients,  their  task  would  have  taxed  to  the  utmost 
their  every  enerjjy.  Here  was  an  utter  want  of  ail 
ret,nilation;  it  was  a  mere  unseemly  scramble;  the 
staff  was  alto^eth.er  deficient  in  strcnj.;tli,  the  com- 
missariat and  purveying  departments  as  weak  in 
power  as  in  ca]iaiity:  there  was  no  real  head,  and 
there  existed  on  all  sides  a  state  of  feelini,'  which  was 
inclined  to  resent  all  non-military  interference; 
whilst  at  the  same  time  it  was  shamefully  obvious 
that  there  was  no  one  feature  of  military  (irder. 
Jealous  of  each  other,  jealous  of  every  one  else,  with 
some  few  brij^dit  cxcejjtions  there  was  little  encourage- 
ment from  any  of  the  ofliciais  for  any  one  out  of  mere 
benevolence  to  leml  any  aid.  The  fai  t  is,  the  stout 
denial  of  the  shameful  c<<ndition  of  the  hospitals, 
made  to  the  authorities  at  home,  iiiuld  not  be  made 
on  the  spot;  the  ofiieials  therefore  walked  about 
self-convietcd.  As  a  warm  friend  of  the  j.;<>vemnu'ir 
sent  out  under  the  ilire<  t  sanction  of  the  War  Otlice. 
1  am  satisfied  it  was  the  wish  of  Miss  XijjhtinKale 
to  make  the  best  of  everything.  She  at  once  found 
the  real  truth  and  cheerfully  uml  j;ratcfully  availed 


I 


Mi>i  Ni^litin<>;ilc  and  Crimean  War  i 


I 


livrself  of  tliat   help  frnm  irrc-,L;iilar  sources  whirh  to 
this  moment  has  heeii  her  thief  Mijiport.' 

N'o  one  at  Iv  nif  had  a  conefjjtion  of  the  total 
;:!;sena'  of  all  su]i])lies  ''ii  the  hospital.  Si'lney 
llerl>crt,  knowing  that  tons  <ii'  hosjjita!  ap])liance^s 
aii'l  thousands  of  sheets  had  been  sent  out,  and 
eiintidcnt  of  navinsx  foreseen  every  enier.Lreney,  had 
,;ssure(l  Miss  Xi^htin,::,ile  that  she  would  hnd 
everythin,^:  necessary  to  work  with.  P.ut  wh.it 
h,.d.  actually  happened  was  thai  the  niediul 
stores,  fur  wirious  reasons,  hid  i^cne  to  wnm.L; 
ports  or  were  buried  under  shell  and  eaiin"i,  in 
the  hold  of  vessels,  while  tin-  Ihane  Oftiee  had 
'■•viT  heen  apprised  of  their  non-arri\al  or  nou- 
eliver\'. 

Within  ten  days  after  she  h:'d  landed  .Miss 
Xi.'^htingale  had  a  kiteluii  titled  up  for  sjieeial 
:k>.s,  which  supplied  nourishment  for  nearly 
:ooo  men,-  and  her  ne\i  \\<'rk  was  to  fit  up  a 
'.iiindry  in  a  pri\ate  housi'  winch  she  rented  f^r 
tile  puqxise.  La\ish  funds  and  stores  had  heen 
I'laced  at  her  (lisjK)sal  jx-rsonally.  and  in  addition 
lb"  Times  had  raised  a  fund  to  he  administered 
lie  siK)t  by  Mr.  M.icd' iii.ild.  hunai;  the  tirst 
■.iiree  months  Miss  N'i,L,'iitin),'ale  provided  lo.ooo 
>!urts  for  the  men,  and  other  necessities  in  pro- 
•    '"'ioii,  out  of  her  own  supplies. 

1'.''  ami  its  Hospitals,  \>y  the  Hon.  and  Rov.  Syilni-y 
10  Osborn.    Irfiiiiloii,  1H55     ]ip.  3   25. 
'.'<■  Sti^ry  oj  Florence  Xighfiu^ali-,  hj   Wintlc.  London, 

.•.0.    p.  6y. 


I  26 


Il'hiury  of  Xursi 


nu 


All  that  oiTici.tl  avulii>rit_\'  rouM  do  tn  make  hn- 
]K>sili'iii  an  cl'icclivc  oik.'  Siihic}-  1  k-rbcrt  diH. 
The  nurses  had  not  been  asknl  fcr  or  wanted  by 
l!ie  military  heads  at  Scutari,  and  ahi"  ugh,  a< 
was  to  l)e  understood,  Mi>s  Xis^htini^ale  and  her 
nurses  were  to  wurk  "in  strict  suhonhnation  f'l 
tlie  medical  officers,"'  it  seems  quite  evident  that 
this  was  meant  to  apply  to  thc^  n'.edical  orders 
only.  Had  she  been  reiUn-ed  to  the  necessity 
of  obe_\-ing  ■■  H'gulations"  all  re  Joi-malion  would 
lia\-e  been  impossible.  That  slie  ha('  lar^e,  ami 
in  some  directions  unh;.m])end,  po^vers  to  re- 
1,'enerate,  to  improve,  and  tn  advise  seems  i)laiii. 
Kinglakc  says  that  tlie  letteis  sent  from  the 
War  OHice  to  Scutari,  though  tactlully  sjjaring 
the  k'elm,L;s  of  th^'^e  in  aulhuntv,  made  it  quit(.' 
plain  that  .Miss  Xightiii'.iale  had  the  govertinieiU 
behind  her,  and;  ad<ls: 

MdSl  happily  this  jjiftcd  minister  [Herbert]  had 
forme  1  a  strong  belief  in  tlic  advantagcF  our  milit.T'y 
hospitals  \v(juld  gain  by  a>  ecpting  uom-anly  aid,  .  .  . 
and  .  .  .  whilst  requesting  tiic  principal  medical 
officer  at  Scutari  to  point  out  to  these  new  auxiliaries 
how  best  they  could  make  themselves  useful,  Mr 
Sidney  Herbert  enjoined  him  to  ree'^ivc  with  atteniinn 
and  deference  the  counsels  of  the  bady-in-Chicf.' 

Prnhably  at  no  time  in  the  liistory  of  war 
nursing  has  an  irrcsistil>lc  public  opinion  forced 
upon   an   unwilling  military  hierarchy  a  lady-in- 

'  Letter  by  Siiliicy  IIciluTt,  Tittu's,  Uct.  34. 

'  ( '^    III  -  vol    \-l     1  h.iu    xi  .  p. 


Mi-^s  Nightingale  and  Crimean  War  u; 

':\i  wiili  siK-h  i^'Xlriisivc  authority,  such  dis- 
cretionary powers,  and  wt'Il  umicrstood,  thou,L,di 
confidential,  relations  with  the  War  Oi'tice.  The 
fact  that  this  was  the  lirst  time  in  the  lii-torv  of 
civilised  nations  (or.  so  f.ir  as  we  know,  of  the 
wnrld)  that  a  nurse  ha<!  been  put  into  such  a 
lidsition  makes  it  especially  intcrcstin,i(  to  hear 
Ahat  those  A\ho  wt're  j)ersonal  witnesses  of  her 
.A'tions  in  this  post  of  uiiexanijiled  difiiculty  ha\e 
tu  say  of  her.  The  l\i\ .  Mr.  Osborne  has  left 
'iiis  description  of  her: 

Miss   N'i;.;luin,L,'ale  in   a])])caraiuc  is  just   wliat   ynu 

V'uM   expect    iti    any   other   well-bred    woman    who 

uiy  have  seen  pcrliaps  rather  more  tlian  thirty  rears 

!  life;  her  manner  and  countcnanie  arc  jirepossess- 

■i\i,  and  this  without  the  possession  of  positive  Lcautv: 

•  is  a  face  not  easily  forgotten,  pleasing  in  its  smile, 

ith  an  eye  betokening  great  self-possession,  and  '^iv- 

a,'.  when  she  wishes,  a  quiet  look  of  firm  determin,ttion 

'  every  feature.     Her  general  demeanour  is  quiet  and 

•.:t  her  reserved;  still  I  am  nuuh  mistaken  if  she  is  not 

itted  with  a  very  lively  sense  of  the  ridimlMus.     In 

■nversation,  she  speaks  on  matters  of  business  wnh 

-  grave  earnestness  one  would  not  expect  from  iur 

lipearance.     She  has  evidently  a  mind  disciplined 

restrain  under  the  principles  of  the  action  of  the 

■itiient  every  feeling  which  would  interfere  with  it. 

' '  has  trained  herself  to  command  and  learned  the 

'  ((inciliation  towards  others,  and  constraint 

<T  herself.     I  can  conceive  her  to  bo  a  strict  dis- 

ii'linarian;   she  throws   herself   into  a  work    as  its 

i.id— as  such   she   knows   well    how    inu.  h    ^u<    I'ss 


I2S  A  History  of  NursiiifT 


must    (leiK-ml    upon    literal    obedience    to    her   cvcrv 

ordiT.     She  seems  to  un(lerstan<l  business  thorou^dilv. 

thou-h  In  me  she  had  tiie  failure  common  to  many 

"heads,"  a  too  i^Teat  ln\-e  of  inanaLrenient  in  the  small 

details   which    had    better   ])crhaiis   have   been    left   l-i 

others.      Her  nerve   is  Wdudirful:    I    have   been   v.iiii 

her   at    very   severe   i>iicratiMns:    she   was   im.re   than 

equal    to    the    trial.      She    has   an    utttr   disregard    .-i 

CMntai;inn;  I  have  knwwn  her  spend  hours  over  men 

dying  of  cholera,  or  fe\er.     The  more  awful  to  every 

sense  any  particular  case,  especially  if  it  vas  that  of  a 

dying  man.    her  slii^dit    f(.nii   wmuI.I   be  .m-u   bendini; 

over   him,   administering   {n    his  ease   in    .  \  erv   wav 

in  her  jj(jwer,  and  seldom  quitting  his  side  until  death 

released    him.' 

SoyrT,  liu-  I"iv!ich  ,//,;,  \\h>  oiiered  liis  services 
in  the  ln'spitals  "(  the  Criinea.  ami  whose  enter- 


tainiiu 


" "  ik  is  lull  (if  h(iinrl\    d.nb 


■  nly  ;m1usiiiiis  {n 
Miss  Nightin<iale  as  he  saw  her  -oir-  abnut  her 
work,  (lesfnl)es  her  with  Frnich  ■,i\aeity  thus: 

She  is  rather  iiigh  in  stature,  fair  in  complexion,  atil 
shm  in  person:  her  physiognomy  is  most  })leasins,'; 
her  eyes,  of  a  bluish  tint,  speak  \..lumes.  and  are 
always  sparkling  with  intelligeme;  her  mouth  is  small 
and  well  formed,  while  her  lips  act  in  unison,  and 
make  known  the  imjjression  of  her  heart— one  seems 
the  reflex  of  the  other.  Her  visage,  as  regards  ex- 
pression, is  very  remarkable  and  one  (an  aim.  ■ 
anticipate  by  it  what  she  is  about  to  say:  alternately 
with  matters  of  the  most  grave  import,  a  gentle  snii' 
passes  radiantly  over  her  countenance,  thus  Tm.Mr 
'  Siiilari  and  its  Hosfiilals,  jjp    as-ib. 


Miss  Nightingale  and  Crimean  War  129 


her  evenness  of  teniixr.  At  other  times,  when 
wit  or  a  pleasantry  prevails,  the  heroine  is  lost  in 
the  happy,  good-natured  smile  which  ])erva(les  her 
face,  and  ycu  recognise  only  the  eliarming  woman. 
Her  dress  is  generally  of  a  gre_\'ish  or  hlaek  tint;  she 
wears  a  simple  white  cap,  and  often  a  rough  aprcju. 
In  a  word,  her  whole  a]ipearanee  is  religiously  simple 
and  unsophisiit'ated.  In  eon'  crsation  no  member 
<if  the  fair  sex  ean  he  more  aniiahle  and  gentle  than 
Miss  Xightingaie.  Remoxcd  fr^  im  lu^r  ardu(jus  and 
cavalier-iike  duties,  wIikIi  require  the  nerve  of  a 
Hercules — and  she  possesses  it  when  reijtiired — she  is 
Rachel  on  the  stage  in  Loth  tragedy  and  eumedv.' 

Mac  IciKiM,  the  J  iiiu'S  cDnniiissioiier,  after  iiis 
return  1"  England  said  nf  Iter: 

Wherever  there  is  disease  in  its  most  dangerous 
furin,  and  the  hand  of  the  spoiler  distressingly  nigh, 
lliere  is  that  incomparable  woman  sure  to  be  seen; 
her  benignant  iinseiue  is  an  inihieiue  for  good  com- 
fort, even  among  tiie  struggles  of  expiring  nature. 
She  is  a  "ministering  angel."  without  any  exaggera- 
tion, in  these  hos])itals,  and  as  her  slender  form  glides 
•  luielly  along  eaeh  corridor  e\  cry  jiour  fellow's  face 
softens  with  gratitude  at  the  sight  of  her.  When  all 
the  medical  officers  liavc.  retired  iuv  tli  ■  night,  and 
silence  and  darkness  have  settled  down  upon  those 
miles  of  prostrate  sick,  she  ma\'  be  observed  alone, 
with  a  little  lamp  in  her  hand,  making  her  solitary 
ruun<is.  The  popular  instinct  was  not  mistaken, 
whieh,  when  she  had  set  out  fnmi  England  on  her 
mission  of  mercy,  iiailed  her  as  a  heroine;  I  trust  she 

'  foyer's  Culinary  Cam patgii,  Alexis  Soycr.  (1.  Ruulled).;!.-, 

I.  ''.liin,    1^57.     jip     I  ;  ^  -I  ;  I 


IjO 


A  History  of  Xursin<r 


may  not  earn  her  title  tn  a  liisj^Iu-r  though  sadder 
appellation.  Xo  one  who  has  ()l)ser\-ed  her  fra.<,nle 
figure  and  delicate  health  ran  avoid  misgivings  lest 
these  should  fail.  With  the  heart  ot  a  true  woman, 
and  the  manners  of  a  lady,  aeeoniplished  and  refined 
beyond  most  of  hiT  sex,  she  eoinhines  a  surprising 
calmness  of  judgment  and  promptitude  and  decision 
of  iharaiter. ' 

Inglehy  Scott  draws  attention  to  two  ciualitics 
of  mind  \\hich  no  doubt  might  haw  arfroiUcd 
egotistical  natures: 

She  was  never  resorted  to  for  sentiment.  vSenti- 
mentalists  ne\er  had  a  chance  witli  l.cr.  Besides  that 
her  character  was  too  strong,  and  its  qualities  too 
real,  for  an\-  symjjathy  with  slialhiwness  and  egotism, 
she  had  two  tdiaracteristics  which  nii-ht  well  damit 
the  sentimentalists— her  reserve,  and  her  capacity 
for  rididde  .  .  .  ;  and  there  is  perhaps  nothing  ut- 
tered liy  her,  from  her  evidence  before  the  Sanitary 
Commi.ssion  for  the  .\rm\-  to  jut  recentl\--iiublishrd 
Xotfs  o)!  .\'!i> stilt;,  which  does  not  disclose  j^owers  of 
ir<iny  which  self-regardant  })ersons  may  well  dread. 
.  .  .  ri'.e  intense  and  exciuisite  huni.initv  to  the  sick, 
underlying  the  glorious  common-sense  about  ;>tlairs, 
and  the  stern  insight  into  the  weaknesses  and  per- 
versions of  the  healthv  .  .  .  lay  open  a  good  deal 
ot  the  secret  of  this  wonderful  woman's  life  and 
liower.  .  .  .  We  see  how  her  minute  economy  and 
attention  to  the  smallest  details  arc  reconcilable 
with  the  magnitude  of  her  administration,  and  the 
comprehensiveness  of  her  plans  for  hospual  establish- 
I  Wintlo,  op.  ci!.,  p.  9;. 


Miss  Xi-;hlingalc  and  Crimean  War  13' 


menls,  ami  for  the  rcihulinn  of  the-  national  rale  of 
ni'irlalitv.  As  the  Ines  <ii  ilie  sick  hang  on  small 
things,  slie  is  as  earnest  about  the  quality  of  a  cup  of 
arrowroot,  and  the  opening  and  shutting  of  doors, 
as  about  the  institution  of  a  ser\-ice  between  the 
commissariat  and  the  regimental,  which  shall  insure 
an  armv  against  being  starved  when  within  reach  of 
food.  In  the  mind  of  a  true  nurse  notliing  is  too 
great  or  too  small  to  be  attended  to  with  all  diligence; 
and  therefore  we  have  seen  Florence  Nightingale 
doing  and  insisting  upon  the  right  about  shirts  and 
towels,  spoon-meats,  ami  the  boiling  of  rice,  and 
largely  aiding  in  reducing  the  mortality  of  the  army 
from  nineteen  in  the  tliousand  to  eight,  in  times  of 
jieaee.  .  .  .  I'^xcepl  for  the  purjjose  of  direct  utility 
she  never  s])eaks  of  herself  or  even  discloses  any  of 
her  o])inions,  views,  or  feelings.  This  rcserx'e  is  a 
great  distinction  in  these  days  of  self-exposure  and 
descanting  on   jiersonal  experience.' 

Even  itiDrc  (lisconuiig  and  graphic  is  Kinglako, 
who  sets  off  liis  stiiii\  iif  Miss  Xightingalo,  to 
whom  lie  (IcMitcs  an  cniiro  c'ha]itor,  with  a  recur- 
ring refrain  i  if  ironic  "  nn  >tif"  against  tlic  "males." 
All  the  W( linen,  he  says,  were  iU'\otci! :  but 

there  was  one  of  them — the  Lady-in-Chief  -  who  not 
only  came  armed  with  the  special  experience  needed, 
hut  also  was  clearly  transcendent  in  that  ubtle 
((uality  which  gives  to  one  human  being  a  power  of 
command  over  others.  Of  slender,  delicate  form, 
engaging,  liighlv  bred,  in  council  a  rapt,  careful 
listener  as  long  as  others  were  speaking,  and  strongly 

'  higlcby  Scott,  op.  1 1/..  PI'.  I- j. 


132 


A  History  of  Xursiin 


r 


Lailv-iii-Chicf  l'.t 


'rrsuasi\-c    wlicncvor    si)eakiii<'- — 


licart   t')  tin 


sjuru 


s  i'nU'rpri.>L'  in 


>i    ahsnhitc    ik'\MiiMn.    hut    her 


quite  of   tin-  kiivl   that 


suM\^    was   nut 


nian\'  iii 


I-: 


X'lnc    k 


ii,t,Maii'l    iinaj^inrl. 


devoted  attenti< 


new  better  than   she  di-i   that    if    kind 


>n  will  sui'fiee  to  eomforl 


it  is  powerless  to  benefit  those  wh 
unless  reinforced  bv  method 


ine  suflercr. 


o  number  thousan' 


orLramsalinn. 


pline;   .   .   .   far  from  bein.i^  a  s]>urner  nf  rul 
so  deep   a   sense   of  tiicir  worth 


niu(  h  more  i 


by  disi  1- 

cs,  she  hai 

as  to  be  seeminL'h 


n  <]an,i,'er  of  hmv^  t-.o  strict  than  too'l 


IlerdetractMrs  said  that  "the  soundness  of  judt,' 


disclost'd  by  the  Lady-in-Chicf  upnn  (|uest 


ra 


pid 


'let'isinn, 


ax. 
ment 


mns  needing' 


ani 


1    liie    apt,    read}-  knowledge   wit 


whi.h  she  always  sccnicd  armed,  mi-lit  be  traced  {< 
the  ]iower  she  had  over  men  m  authorit\";  the  the 


hemt 


it  seems,  that  1 


(>r\- 


these  ol'tieia. 


iccause  they  felt  her  ascendent, 


s  were  always  lon,i,'inK^  to  ,^rivc  li^r  the  ver 


choicest   and   best   of  their  facts 


cr\- 


and   ideas        But 


smiplcr  ex 


Iilanati'iu  of  the  abundant 


at  which  ]ici  i])Ie  w 
d 


ondercd,  nw']\{ 


mental  resource, 
"und  in  the  keen 


discrumnation   enablir.i^r   i^.,-  j,,  j^,,]i^ry   ■^^    ^ 


whether 


anv  o 


f  the 


le  mstatil 


treasured  or  set  at 


words  addressed  to  her  should  be 


nau'Mit. 


At 


"csides  that  her  jXTt'cct  knowlcd; 


:c 


of  h( 


pita]  biisiiK'Ss  and  h' av  t<  i  coiiilucl  it: 

Howr^iT  'a-i-matm..:.  th,'  -if^  without  which  she 
could  never  have  achieve<l  what  she  did  was  her  fac- 
ulty of  conquering  dominion  over  the  minds  of  men; 
and  this,  after  all,  was  the  force  which  lifted  her  fr-.in 
out  the  ranks  of  tho.e  who  w^rc  only  •'ablr"  to  the 
liei,i,dit  reached  by  those  who  are  called  "j,'reat." 
The  will  uf  the  males  was  always  to  yo  on  performini; 


Miss  Xig-htingalc  and  Crimean  War  i 


their  accustomed  ilutics—  if  need  be,  even  to  death 
-  -in  that  .i^Toove-^oinj,'  state  of  hfe.  .  .  .  The  will  of 
the  woman,  wliile  stn^nger,  Hew  also  more  straij^dit 
to  the  end;  for  what  she  almost  fiercely  sought  was 
.  .  .  not  to  make  ,<;o.m1  mere  cfjuations  tjctween  ofheial 
codes  of  dut}-  and  ot'ticial  acts  of  obedience,  but, 
overcoming  all  obstacU'S,  to  suci'our,  to  sa\-e  our 
prostrate  soldicr\-,  and  turn  intcj  a  well-ordered 
hospital  the  lu^ll—the  a])i)alling  hell— of  the  vast 
barrack  wards  and  corridors.  Xature  seemed,  as 
it  were,  to  ordain  that  in  such  a  conjuncture  the  all- 
essential  power  whii  h  <iur  crampei],  over-disciplined 
males  had  chosen  in  lea\e  unexcrted  should  j)ass  to 
one  who  could  sei;a>  it,  should  pass  to  one  who  could 
wield  it, — should  pass  to  llie  Lad\-dn-Chiefd 

.Mr.  Macdnnald,  the  7"/;;/r.s- commissioner,  finding 
that  ■'iK.thin.L,^  was  wanted"  by  the  army  oOicials, 
now  turned  to  .Miss  Xi;.,ditint::alc  ami  worked  in 
conjui.ction  witli  her.  She  had  with  her  lier 
friends  Mr.  .and  Mrs.  I]raeel)ri(]ge.  the  latter  of 
whom  undertook  the  house keepinL,^  and  an  as- 
sistant whom  we  may  well  tx'lieve  to  ha\-e  been 
invaluabU'  was  a  youn,!j[  man  wdio  came  (jut  froin 
London  to  "fa.ij"  for  her,  writing  letters,  running 

'  Kinyhke.  op.  cit..  \,,\.  vi.,  pp.  41  (,--42.,.  Interesting 
ti"U-s  ;ire  also  to  lie  found  in  the  French  histories  (if  the 
war:  "This  frail  young  woma-i,  who  was  seen  Kom^,'  on 
h.rsel.ack  from  one  hospital  to  another,  embraced  n\  her 
si.lieitude  the  sick  of  three  armies  "  I^a  Guerre  dc  Crinuc, 
M.  L.  Baudcns.   1858.  p.    104.  There,   t,>   care    for  them, 

a  voimg  woman,  be;mtiful,  rich,  inL.-lligent.  of  infinite 
:!'>r;t  and  rare  di.'stineti.jn,  .Miss  FlorencL  Nightingale,  had 
kit  family,  friends,  and  home.  "  Hisioire  de  la  Giurrc  jV 
i-fimie,  Camille  Rousset,  1877,  vol    ii  ,  p    13. 


134 


A  Ilistorv  of  Xursi 


ni 


errari'ls,  rind  making;  himst'ir  j^a'ncrallv  useful.' 
( 'n  an-ival  thf\-  took  up  their  quarters  in  the  fa- 
niMUs  tower  ami  the  nurses  wvw  appdinte'l  to 
their  (ii\isinns. 

Let  us  now  follow  the  narrative  of  one  of  the 
nurses  as  told  1)\-  herself: 

We  landed  at  the  wharl",  and  diinliin;^'  the  stce;> 
hill  tnuiid  ourselves  at  the  main  ,miard  or  prinei])a! 
entrance  to  vSeutari  Harraek  li()S]utal.  The  hospital 
is  an  immense  square  huildini,';  thn>e  ion^'  eorrid'Ts 
run  completely  nnmd  it,  and  it  is  three  stories  hit,di. 
Xumherless  apartm.  nts  ojien  out  of  all  tliese  eorridurs, 
which  arc  called  wanis.  .At  eai  h  corner  of  the  huild- 
inrj  is  a  tcMver.  The  main  ,<;uard  divi.lcs  A  (orridor: 
turning,'  to  the  left,  after  ])assin,<,^  throu-h  one  or  tw. 
divisions  fnan  which  tlie  ,^uard  rooms  o[)en,  we  came 
to  the  sick. 

To  avoid  the  cmI<1  air  of  the  lonj^  corridor,  wooden 
partitions  were  pur  up,  and  the  spaces  between  these 
were  called  divisions.  We  made  our  wav  throuL,'h 
the  double  row  of  sick  to  the  tower  al  the  corner 
(Miss  Xi,i,ditin<Tale's  <|uarter-^o  the  smell  in  this  cor- 
ridor of  si(  k  was  (|uitc>  o'.arpowerini;. 

On  arri\dn.i;  in  .Miss  .\i,L,'htin,i:alc's  ipa.arters  we 
entered  tl;o  lari^e  kitchen  ..r  hah.  from  which  all  tlic 
other  rooms  opened.  There  were  four  rooms  on  the 
lower  story,  occupied  as  follows:  Mr.  am!  Mrs.  Braco- 
bridpe  in  one;  Miss  \i,i,duin,-ale  in  another;  the  five 
nuns  in  the  third;  fourteen  nurses  and  <<uc  lad\-  in  the 
last.  A  staircase  led  up  the  tower  to  two  nther  rooms; 
the  first  occupied  by  the  Sisters  from  Miss  Sellon's 
and  other  ladies,  the  second  by  tlie  nurses  belon^dnj; 
'  Kinglakc,  op.  cit. 


Miss  Nightingale  and  Crimean  W: 


ir  1 


j:) 


to  St.  John's  traininji:  institution.  The  kir.hcn  ^vas 
usci  as  Miss  Xi-htin-ale\s  e.xtra-dict  l<itrhcn.  Prom 
this  ro<,m  u-en;  (iiscributed  quantities  of  arrowroot 
sago,  rirc  pud-h-n-s.  jelly,  beef-tea.  and  lemonade,' 
upon  reouisitions  made  by  the  suri;eons.  This 
caused  great  c.^mings  to  and  fro:  numbers  of  orderlies 
were  waiting  at  the  door  with  requisitions.  One  of 
the  nuns  or  a  lady  received  tjumi.  and  saw  tliey 
were  .signe.i  and  eountersigne.i,  and  then  served 
them. 

We  used,  among  ourselves,  to  call  this  kitchen 
the  tower  of  Babel,  from  the  variety  of  languages 
spoken  in  it  an<l  the  confusion.  In  lac  t,  in  the  middle 
of  the  day  exerything  and  everybodv  .seemed  to  be 
there:  boxes,  parcels,  bundles  of  sheets,  shirts,  and 
^'Id  linen  and  llannels.  tubs  .,f  butter,  sug.ar,  bread, 
kettles,  saucepans,  heaps  of  books,  and  of  all  kinds 
of  rubbish,  besides  the  diets  which  were  bein-r  dis- 
pensed; then  the  people,  ladies,  nuns,  nur.scs,  orderlies. 
Turks,  Txrceks,  French,  and  Italian  servants,  officers 
and  others  waiting  to  sec  Miss  Nightingale-  all 
passing  to  and  fro,  all  intent  upon  their  own  business. 
and  all  speaking  their  own   language. ' 

■Mr.  Osborne  h;,s  also  lc!L  a  lively  dcscnption 
of  the  nurses'  tower: 

\Viiate\-cr  of  ncgkvt  ma)-  attach  elsewhere,  none 
can  be  imi.utc.Ml  here.  ]-rom  his  tower  t],,wed  that 
well-directed  stream  of  untiring  benevolence  and 
eharitalile   exertion    which    has    been   deservedly   th.e 

-■  '^.Vn  Hospitals  and  Jdclish  Aursrs.  hv  .-,  I.^.lv  \'nlan- 
'■•■r.  LoiKion,  ..S50,  vol.  i.,  pp.  o(.-f„,,  Th,^  la.iv  was  one  uf 
tiK'  second   party. 


^-.(> 


A  IlistoiA  of  Xursin-r 


theme  of  so  muel,  i^rai^e.  Here  tliero  has  been  no 
idleness,  no  standing'  still,  no  waitini,'  tor  oniers 
from  home,  no  (]uil.l,lin,-  u-ith  any  reriuisition  ma.le 
ni.on  those  who  so  cheerfully  adminislered  the  stores 
at    their    dis[K)sal. 

Knterinir  the  door  into  the   "Sisters"   !,,wcr,   yo,, 
at   onee   found    yourself   a   spectator   of   a   busy  and 
most    interesting    scene.   ...    In   tlie   further  corner, 
on  theri-ht  Iiand  side,  was  the  entrance  to  the  sittinj,'-' 
rM..ni  oceu])ied    by   Miss   Xi-hlin-de   and   her   friend^- 
the    I5racebrid,L;cs.      I    .,liall  ever  recall   with    the   Uvc- 
liest  satisfaction  the  many  visits  I  paid  to  this  apart- 
ment.     IIer(-    were    hcM    th,,se    councils    over    which 
Miss    XiKduin-aie    so    alily   presided,    at    which    were 
(Licussed  the  measures  necessary  to  meet  the  daily 
varying    exii,a-ncies    of    the    hospitals.     Fr<,m    hence 
were   ^iven    the    oniers    which    ix-ulated    the    female 
stalf,    workin.^r   under    this   most    .t^dfted    head.     This 
too  was  the  otTice  from  which  were  sent  those  many 
letters  to  the  ^^overnment,  to  friends  and  supporters 
at  home,  which  told  such  awful  tales  of  the  suflcrin,i;s 
of  the  sick  and  wounded,  their  titter  want  of  so  many 
necessities,     ilere  mi,-ht  be  seen  the  Times  almoner, 

takm-  down  m  his   noted k  from  <lav  to  day  the 

list  of  thin.L's  he  was  pressed  to  obtain  whitdi  mit^ht  all 


'.vith  a  little  acti 


\"it\-  !i; 


:ive  heen  j^rovi.led  as  easily  bv 


the  authorities  of  the  hospital. 

To  attempt  the  narrati^.n  of  the  business  trans- 
acte<l  in  this  ro,,ni  would  be  a  task  bevond  mv  ],owers. 
It  was  of  a  nature  eomprehendini,'  s.iniewhat  of  the 
detail  of  every  reco<,mised  'Mcpartment  "  :  it  embraced 
the  eonsideration  of  everv  failure  of  dutx-  ,.n  the  part 
of  "authorities"  at  hon,e  and  on  the  spot;  it  ainud 
at  the  attainment  of  onicr  and  humamtv  bv  Hmitcd 


y. 


Mi^s  Nightingale  and  Crimean  War  137 


nit-ans,    to    be    directcl    aL,'ainst    the    wiaest    pnssihle 
tic'M  of  disorj^anisation.' 

Li't  us  continue  the  narrative  of  the  La(l\- 
\'oluntccr: 

Two  days  after  ni\-  arri\-a!.  Miss  Xi'^htini^ile  sent 
fnr  me  to  go  with  her  round  the  hospital.  (Miss 
Xi.,'!uini,'ale  .icenerally  visited  lier  sjieeial  eases  at 
ni'^ht.)  We  went  nm.-d  the  wiiolc  (,f  iho  seeond 
story,  iiUM  many  uf  the  wards  and  inln  i.ne  of  the 
upper  eorrid'.rs.  It  seemed  an  endless  walk,  and  it 
was  one  not  easily  fMrL,"itten.  As  we  slowlv  jjassed 
alonjj  the  silence  was  jirufMnnd;  \-.  rv  srld'im  <iid  a 
ni'ian  or  ery  fr^ 'in  tln'se  mnltitnd.  s  uf  .Jeejily  suf- 
fiTinj^  ones  fall  nn  our  ears.  A  <lim  li-ht  Ininied  here 
and  there.  Miss  Xii,ditini:ale  carrie,!  Iht  lantern, 
whieh  slic  Wduld  set  down  hi'fcire  she  Lent  n\er  any  >,( 
the  patients.  I  nuieh  admired  Miss  Xi<(luim,'ale's 
manner  t.)  the  men— -it  was  so  tender  and  kind. 

All  the  u)rri<lors  were  thiekh.-  lined  witli  heir, 
laid  on  low  trestles  r-ai-^ed  a  fe'>v  inches  frnm  the 
ground.  In  the  wards  a  diwin  runs  round  tiie  rM.im, 
and  on  this  were  laid  the  tra'v  hed.s.  and  the  sutltTers 
en  them.  The  lnwpital  was  iTMwded  to  its  fullest 
extent.  The  huildini;  has  siiiee  lui'u  reckoned  to 
hold  with  cnmtdft  se\-enfeeu  hundred  ine!i ;  it  then 
held  between  three  and  fMur  thousand.  .Miss  Xi,i,dit- 
iiiijale  assi^med  me  m\-  wmk  -it  was  li.iH  A  corridor, 
the  whole  of  H.  half  C,  [\iv  whole  of  I  (,m  the  third 
story),  and  a  the  wards  leading  out  of  these  respce- 
tive  corride.s,  in  eaeh  corridor  there  were  fifteen  of 
tliese.  exeept  in  No.  J.  where  there  were  only  six. 
This  work  I  was  to  share  with  another  la  ly  and 
'  Scutari  and  its  Hospitals,  pp.  aj-i4. 


unc 


l.v^ 


A  I  li>t()r\-  of  XurM'nj^- 


nurse.     The      'nnl)er    <  ■{    [i.itieiUs    uivler    our   e!iari,'e 
wa-;.  as  tar  as  1  emiM  reekMii,  ahout  lit  teen  liundrcl. 


Miss  Xi,L;luinijale  told  us  onl\-  to  attend  to  tli 


nse 


in  the  divisions  of  tliose  suri,'eons  who  wished  for  our 
s 'rviecs.  She  said  tlie  staff  sur<,aMin  of  the  division 
was    willini;    we    should    work    under    him.    and    slie 


<    .arj,'ed    us    never    to    do   an>-tliii 
with(JUt  the  leave  of  tlie  doetors. 
It    seems    simiilv    impossible    t 


ir   the   patients 


to    (leseri 


lie    Sent, 


in 


li"^liital  at  this  time.  Far  abler  jiens  have  Iriel 
and  all  in  some  measure  failed;  for  what  an  eye- 
witness saw  was  past  deseripti(jn.  l-^xen  those  who 
read  the  harrowing  aeeounts  in  the  Times  and 
elsewhere  eould  not  h;'\e  ima,i,nne  1  tlie  full  iMrrur  (jf 
the  reality.  As  we  passed  the  i orridors  we  asked 
ourselves  if  it  was  a  terrible  dream.  When  we  woke 
in  the  mornini,',  our  hearts  sank  down  at  the  thouijht 
of  the  woe  we  must  witness  that  dav.  At  nij^ht  w< 
lay  down  wearied  bt^yond  exj)ression ;  but  not  so  much 
from  physical  fati,i,nie,  tho-i^li  that  was  Rrcat.  as 
from  the  sickness  of  heart  from  livinR  amidst  that 
mass  of  hopeless  sufTcrin.^.  On  all  sides  prevailed 
the  utmost  confusion;  whose  fault  it  was  I  cannot 
tell — clear  heads  have  tried  to  discover  in  vain: 
jirobalily  the  blame  shouM  have  been  shared  b)  all 
the  departments  uf  the  hospital. 

We  could  not  y^vt  the  assistant  surgeons  to  write 
out  the  number  of  the  re(juisitions  which  wen 
necessary  in  order  to  j)rocure  these  materials.  At 
last  some  of  us  persuaded  one  or  two  of  our  surRcons 
t>  write  a  requisition  for  <lry  stores,  that  is,  for  tins 
of  i»reservcd  beef-tea.  and  for  lemons  and  sugar  to 
make  lemona<Ie.  .  ,  One  diiriculty  only  remained, 
t.  c  ,  hot  water.     It  was  of  course  necessary  to  make 


Mi^s  Xi-htin-;ilc  and  Crinu-ui  War 


l.iO 


the  birf-tra.  aivl  alsD  for  tlic  I 
was  S(i   unwholcs' 


t'liinnai 


as  tlie  water 


l.nilinji;.     Wo  i()nlri\-c<l  to  buil 


nic   it    iMuld    iMt   be  usoil   \vitli(jut 


tii-S  on   the  stoves  in   t 


water  in  snuill  (niant 


;u'   rorriiiors  and    wan 


v,-as  a  slow  proecss,  but  still  we  suci  cedeii. 


irn  was  jmt  a  stop 
.  the  inspect' tr- 
ine in  the  wards, 


our  only  means  of  assistiiu'  the  men 


was 


Our  plan  of  thus  hrlpiii>,'  tlie  n 
tn  by  an   order  from    Dr.  Cumminj. 
general,  that  no  eookin.i^  was  to  be  d( 
and  thus 
ended. 

\Vc  scld'im  drc'^sed  the  wounds,  as  there  were 
.rissers  who  j.erformeil  this  oliice.  and  ihe  ijreater 
number  of  patients  were  cases  of  fe\crand  <lysenterv, 
who  needed  .onst.-uit  attcnti-ii  and  nourishment, 
frequently  athiiinistercd.  in  small  'I'lantities,  and  this 
we  were  now  not  sufYere.J  to  <rive.  All  the  diets  n<.t 
i'^<iied  from  Miss  N'i,i,ditin^'ale\s  kitdien  were  of  sueh  a 
I'ad  quality,  and  so  wretchedly  looked,  that  the  men 
"ften  could  not  eat  them.  After  a  iii^n  had  bi  rn  piit 
■  n  half  or  even  full  diet,  the  sur^^'eons  were  often 
ii.'cd  to  return  him  to  spf)on  diet  from  his  not  beini,' 
aljle  to  eat   the  meat. 

it  was  very  hard  work  after  Dr.  Cuinmin.iij's  or- 
.  r  had  been  issued  to  pace  Uie  corridor  and  hear 
I'erhai)s  the  l<nv  vr)ice  of  a  fever  patient,  "Give  me  a 
drink  for  the  love  of  God!"  and  have  none  to  pive— 
f'T  water  we  dared  not  j,nve  to  any;  or  to  sec  the  J.M.k 
"f  disappcjintment  nn  the  faces  of  those  to  whom 
We  had  boon  accustomed  to  ^ive  the  beef-tea.  The 
assistant  surgeims  were  very  sorry.  th"y  said,  for 
the  ahcration  but  they  had  no  power  to  help  it— their 
duty  was  only  to  nlx-y.  On  one  occasion  an  assistant 
sitrijoon  told  us  that  Dr.  Cummin^  had  threatened 
irrest   him  for  having  allowed  a  man  too  manv 


140 


A  History  of  Xursi 


ncr 


cxlnis  on  r].v  diet  ml!.     Aini,]  all  tli 


list 


ress   of   Scuiari    hos[)it; 


ne\-er  lost  sij.'! 

ill 


'f, 


0  confusion  an] 
niiliiary    ilisriplinc   was 


ami  an  iiiirin,L,n'niciit  of  (jnc  of  its 


sinaik'st   ol)S(;rvanccs  was 

nu-n  (lir   fruni  iir'^kH't. 


Worse  tlian  lettin.L,'  twenn 


I'k'ii^'t.  .  .  .  The  want  of  clean  Inun 
was  bitterly  lelt  at  that  ti:ne  m  S.  -atari.  II,, u-  it  was 
issue.)  from  the  stores  was  a  in\stery  iv,  une  enuM  ever 
uiira\  el.  !f  things  were  sent  to  he  washed  thev  never 
ivlurned.  and  tlure  was  n^t  the  shghtest  ..rder  ur 
re-ulanty  in  the  issue  ,,{  linen,  either  sheets  or  shirts 
Towels  an.i  porket  handkerehiefs  were  both  considered 
unnecessary  lu.xurus  f,,r  the  sol, hers,  and  eould  he 
ubtaine.l  only  from  Miss  Xi-htin.nale's  free-gift  store 
and.  generally  sjHakin-  nnly  In.m  theni  c'.uld  llaii- 
nel  shirts  be  had    . 

C-Mufus,,,,,,  indeed,  so  prrvaile,!  in  all  'juartcrs  at 
that  unhappy  time  that  ihnu-h  rjuantities  of  things 
were  sent  to  Scutari  but  few  ever  rcviehed  the  sulTerers 
.or  whom  they  were  destined.  Kverv  ship  that  eame 
in  brought  to  Miss  Nightingale  large  packages  of  every 
imaginable  arti.le  of  wearing  afiparel,  ...  It  was 
a  eominun  thing  t<.  fi,.  1  men  w,th  sheets  and  shirts 
unchanged  for  weeks.  1  have  ,,pene<l  a  collar  of  a 
patients  shirt  and  f,,und  it  hterallv  line.!  with 
vermin.  It  was  common  to  hnd  mencovred  with 
sores  from  lying  in  one  position  on  t!ie  luird  si-., 
beds  an.l  coarse  she.is.  an<i  there  were  no  pdlnws  to 
put    under  tlicni, 

A  great  deal  of  sickness  prevailed  am.-ng  ourselves- 
two  nurses  at  thi.s  time  were  Iving  ,11  ^^uh  fever  on.' 
not  expected  f.  live;  two  of  the  five  nuns  were  in  the 
same  stnte-they  b.„h  lay  for  days  at  the  point  ef 
death,  but  ultimately  recovered.  Dun,,,,  .Ik-  wi.  i. 
of  their  illness  they  remained  in  the  room  where  the 


Mi>-.  \it;htin<ralc  and  Crimean  War  141 

...:vr  f.tlRT  Sisters  sK-pi  and  at(  .  There  was  no 
intiniKiry  u>  rciiK.ve  the  sick  la.hVs  f.  Tlie  sirk 
mirses  were  taken  to  a  room  outsiMe  the  hosiii;,,!.  Ot" 
course  among  kidics  and  nur^  s  not  ,11  v.uh  fewr 
many  were  laid  up  for  a  day  or  two  at  a  time  !-Mmo\er- 
fati.ijuc  and  want  <,{  jjropor  food. 

Our  hie  was  a  lal)orious  one:  wc  had   to  sweep  ^ur 
'wn  rooms,  make  our  beds,  wash  up  M„r  dishes,  etc.; 
and   fetch   our  meals   from   the   kitcli.n   1k1..u.      We' 
lit  to  fmr  wards  at  nine,  reiurned  at   iv.o,  ^^,■m  up 
at  three  (unless  we  went  out  for  a  w.ilk,  w  hit  h  wc  had 
permission  to  ,],,  at   this  Ii.,un,  returned  ..i   h;df-pasl 
five   to  tea,    th.n    t.,    the    w.irds    a.-ain    nil    hall  past 
nine,  and  often  a.-ain  for  ;in  hMU,-  to  our  speci.il  eases. 
We   .suffered    greallv    fM,-  \,..nit    ot    pr.,p,r    fo,,d. 
"ur  .Het   consisted   of  the   coarse  sour  bread   oi    the 
country,  tea  without  tiiilk.  butter  so  rancid  we  ■  ould 
not  touch  it,  and  \erv  bad  meat  and  i)orter;  and  at 
night  a  glass  of  wine  or  lirandw 

The  quantity  of  \ermin  in  the  wirds  was  past 
'■inception;  the  mens  clot  lies  and  beds  swarmed 
with  them,  so  did  every  room  in  the  hospital.  Our 
clothes  had  their  lull  -li.are,  and  the  mi.erv  thev 
caused  us  was  very  gr-at  ,  we  never  .^Icin  niMn.  uuin 
an  hour  at  a  time  because  of  them. ' 

liy  riiristnias-tinie  cleanliness,  order,   suitable 

' '  'i">l  clothing  had   transformed   the  wards  .  .f 

thedcncral  and  the  Barrack  hospitals;  hiit,  tliM,,;^-h 
fasy-goinjT  critics  now  i)ronounccd  them  to  ]„•  in 
IKTfirt  condition.  Miss  Xightingale  was  Imnletid 
with  the  heaviest  ,tn.\iety,  for  the  state  of  the 
'  EasUrn  Hospitals,  etc.,  vol,  j.,  j,j,.  hg  94. 


142 


A  I  lihloi-v  of  Xiirsin; 


liuiMitii^'s  as  rc.i^^anls  arran,:4rinL'iUs  Inr  thi;   (ii.>[,< 
.sal  lit   hr\va,L(r  was  so  hidcms  tlial  il  can  mii1\-  1, 


(tc'scniieil    in    tcchiiiralit n 


hvvv   was,    in 


no  ilraina,ij;c,  no  i)lninlr:n,L; :  there  were  almost 


sanilarv  eonwniem 


11  had 


no 
i!l  lieen  known  i;i 


time  to  haw  Oeen  remeiHeil.     It  \v, 


IS  ni  )t  remeihei 


ano  tile  p,.li(,-nls  sent  in  the  '.lospilals  were 
(K'ath     traps.      .Miss      Xi^j^hlingale      states: 
deaths  on  cases  treated  were   no  less  than 
looo,  or  ne.arlv  one  in  three."  ' 


sent  to 


nr 


11  was  th' 


:\v  >\\'lv' 


Ins  criminal  n^ 


led. 


till 


s  ollici.il  mnrder,  that  comjielied,  .Miss  Xi,L;lU 


Ill- 


ale  to  w.ir  sin'.^dedianded, 


e.\ee]it  for  Sidiiry  Her- 


Dei 


t  M    supjiort,  a.i^Minst     the    1  lure.meracy    of    thr 

and    eiii^nneerini:   staffs. 


irin\-    ninheal,    sanitar\- 


It 


was  her  ur-ent  reports  and  her  itemised  stale- 


metus  ,ind  demands,  says  Kin.L^^lake,  that  finally 
hnm.udit  .dM.nt  the  undertakini;  of  e\tensi\-c 
i-ineerin.L;  \Mirks,  which  were  cMmpletcii 


sanitar\'  ei 


in  jniir,  i.S5^.  when  l  he  dcith  r.ite  i\ 


I  ooo  I  Ml  ca.ses  ire 


.led"  i.MiSS  N 


iL;htin'Mi 


■  )     jj  ])er 
e's  words  I, 


and  he  hints  stron-rly  that  e\c'n  in  the  \er\-  wonl- 
iiil;  "(  the  din'ciinns  which  came  out  from  ihe 
\\  .ir  Office,  and  especi,dl>-  in  the  man.i.itcs  to 
speed    and   celerity,    there   was   a    minuteness  of 

f  t  he- 


detail   which  stict^csted  the  persrma! 
Lady-in-Chief  therein. 


snart^  o 


'  Xotcs    on    Matters    afjcrthig    the    Health,    Elfic 


Hospital  A  dm  in  istration 

.'Si 

"arrj.si 


N'i^jhtitijjak'.     Pre; 


o}  the  British   Army, 
l>y    Rc'iuest    to    the 


lency,  an : 

Florence 

Secretary   of 


State  f.>r  AVar.    Harri.sou   &   Suns,  London,    ICH58.   Preface 


sec.  I,  p.  x.xvi. 


Miss  XiM-htin^-alc  and  Crinicaii  War  143 


his  tra-Mc  winttTof  iS:; 


s;nv  what  K 


iiv. 


ik( 


calls  an  mtcivst in.i,'  trial  nf  I, rain  puwvr  an-l  sjHnd 


hctwi'cn  ihc  WMiiian  at  worl- 


and  till. 


ii"\vrr 


At   t 


males     in 


ir  same  time  tlvit   '1 


e  ntirses  saiK'd 


trliament 


a])])(  )mte(l  a  c-i  ininii 


the  Crimea  an' 
the  irreatest    eek 


SMMn   to  m  (,ut  to 


iin-esti,L:ate  th 
it\-    in    Iran 


:uiitions. 


With 


11    transportation,   and    ;  I- 
lowin-  for  nr)  delavs,  it  could  only  have  reported 
hack   to    Parliament    in    tlnrteen    weeks,    whereas 
hy  Christmas  Miss  Xi-hlin-ale  had  a  fairlv  -o,  ,d 
system  runnin;;.      The  commissi- m  set  torth  with 
n<«j)owers  todoau,i,'ht  but  report,  hut  aetin,!/  on  a 
letter  from  Miss  Xi-htin-ale  Sidnev  Ilerhert'wrote 
tn  them  to  take  ste])S  on  the  sp.  .t  to  ha\e  defi- 
ciencies correete.l.     Thev  only  received  this  order 
in  time  to  be.o;in  makin-  recommendations  on  tlie 
2jnd  or  2,vi  <  of  January— and  this  for  the  troops 
"nl\-;    their    report    fron;    Scutari    wa,s    forwarded 
alKmt    tlie    2^rd    of    Fri.niarv,    reachm-    London 
ahout  the  _^oth  -f  March,  in  time  Lt  the  ir'-iisters 
to  ,c[et  their  orders  out  for  the  late  sprin,L,r,  t  aree  or 
t-nr   months    (says    Kin-lake)    after    Si"r    Gcorj^e 
iSrown  (at  the  outset  liMsiile  to  Miss  Xightin<,-ale) 
sawperfectiMii  in  thr  hospital  wards,  and  ascrnied 
it  to  wnmanly  eneri^'ies. 

Thus  sorrily  iaj,r.n;ed  the  males  [he  cnncludes]  in 
tluir  undesijjned  tri.il  ,,f  s,)ood  and  power  with  what 
proved  to  be  not  oiilv  the  swifter,  nut  onlv  the  more 
a.Ljile  mind,  but  also  the  hi-her  <  aparit  v  f,,r  executive 
bu.siness,  ami  even  rhe  more  intent   will  ' 

'  Kin.ttlako.  op.  <i,'..  vol.   vi.,  j.p.  44V-445. 


T 


144 


A  History  of  Nursin*;- 


After  her  return  from  the  Crimea  Miss  Nipht 


a\'e  testimonv 


in  which  slie  outhneil  a  wo 
tinn  for  iniht>ir\-  hospitals  anii 


111- 


hetore  a    mval   eommission 


rkinij^  ])lan  of  ory^ani 
■icily  pointed 


sa- 


out 


the  railical  ilcfccts  then  ohtainint:  as  follows: 


[n  the  military  .^'ncral  Imsjiitais, 


th 


ev  are  n  -w 


ciiiisiii  uicil,  t h 


e  t,'.  >\-erinii,i,'  i)(.\ver  is  wantin-' which  1. 


It- 


suiHTiiir 


auth'irity  can  compel  tlv  CD-ordina'c 
'Iciianmcnts  withm  ,he  Ixisintal  to  lae  complitr 
co-orihnation  necessary  for  success.  [She  compares 
till"  na\-al  hospitals,  v.liere  there  is  one  head,  an.! 
continues:]  (Jne  execut i\-e.  responsihle  liead,  it  seems 
to  me,  is  what  is  wante  i  in  a  .f,n'neral  hospital,  c.ill 
linn  ■^nwrnnv.  commandant,  nr  w  hal  vou  will,  and  Ki 
It    he  his  ;m)1c  command. 

The  dejiariments  should  not  be  many: 

1.  A  .<,'ovcrnor,  solely  resjjonsible  for  everythinj,' 
e.Kcept  medical  treatment. 

2.  A  iirincip.al  medical  oificer,  and  his  stalT,  relieve! 
ot  all  administrative  duties  and  strictly  professional. 

,■;.  A  steward  who  should  fulfil  the  duties  of  jjur- 
vcyor.  commissary,  ami  harrackinaster,  and  supply 
e\er\  iliin,!,'.  suhjecl  to  tlic  s^overnor. 

4.  A  treasurer,  who  should  \)c  hanker  anil  ])av- 
niastcr. 

5.  A  supcnntenilcm  of  hospital  attendants,  wlm 
should  undertake   the   ilirection   of  cooking,  washini,', 

■  77.'. ■  Saai/arv  (\,„clil2c<i!  ,<;  the  Iniiv;  \  Report  of  the 
Coiniiii.s.sKm  .ippuiiurd  to  imiuirc  into  tlu-  RfKul,iticni.s  alTt\t- 
iiiK  tho  Sanitary  ComlitKius  i.f  the  .\rniy,  the  org.misation  of 
Mihtary  Ilnspitals,  the  treatment  c.f  t!ic  Sick  and  Wounded. 
I're.sented  to  hoth  houses  ot'  P.irli;iinpTit  by  comin.md  of  lur 
Majesty.      Lou, Ion,   iS^H.      Wr^tniiintcr  Rrrirw,  J.in  .  tSsg. 


Miss  Nightins^^alc  and  Crimean  W: 


ar  145 


care  of  hospital  f 

All  of  these  ortircrs  to  1 


nrniturc,  and  ,i,'ovcrnmcnt  of  orderlies. 

>v  aj. pointed  at  hf.nie  l,y  the 

conHng  to  this  plan  the  govcrn- 


War  Department.     Ac 

inent    would    culminate    the    functions    of    rpiarter- 
master-general    and  adjutant-general  and,   un.Kr   the 

iini  for  that 
LaiTyinj,' 


advice  of  a  sanit 


:irv  oi'ficer  att 


lelied   to 


purjjose,    would    h 
lut  the  works  ai 


,isei 


lely   res])onsi 


hie    f. 


and  i<,r  (  n,!.;a,<,nng  the  requisite 
labour.  With  re-.ir.i  to  the  mod,.  ,,f  supplv  kt  the 
steward  furnish  ihr  hosi)ital  according  to  a  hxed 
<>ale  previously  agreed  ujton. 

With  regard  to  fo,,d  h-t  the  ^teward  make  contracts 
-ihject  to  the  govi^rnor's  aj.proval.  and  with  power  to 
iuiy  in  the  markets  at  the  contractor's  expense  if 
the  contractor  fails.  A  scheme  of  diets  should  Le 
instructed,  according  to  the  most  approved  authori- 
ties, in  order  to  save  the  cumbnms  machinery  of 
extra  diet  rolls.  Equivalents  might  be  laid  down,  so 
as  to  allord  the  necessary  choice,  dependent  on  the 
:-uure  ()f  the  climate,  the  seas.m  of  the  vear,  the 
■^•.ate  of  the  market,  the  pnuluce  of  the  country,  vU:. 

This  schcflttlc  .s1k)\vs  m  brief,  anr]  her  reiriarkal)Ie 
monograph  on  the  Brili.sh  army  in  detail,  the 
uinentahle  akscnce  of  all  intelligent  foresight 
■•yhich  made  the  Crimean  calamities  s(i  spectaetihtr. 
Common-sense  was  stiflecl  in  routine  and  regula- 
:: 'Hs;  these,  in  turn,  were  fossili.sed  by  pr'offs- 
_^ional  lealotisN-,  timorousness,  and  selfishness. 
This  shines  otil  clearly  from  all  the  testimony 
■iven  later  before  the  commission,  and  is  thrown 
into  even  stronger  relief  by  apol,,gi,(s,   while  the 


experiences  of   later   wars    ha\e   reduplicated 


ill 


VI  iL.   II 


I4'> 


A  History  of  Xursini^ 


III"    Miss    Xi,L,'luin_u;;i](.''s    accusations,    aiiil    wrified 
licr  v,arniiiL,'s. 

llcr  Idler  of  J:,!!.  Sth.  t<.  Si.lncy  llcrhort' 
slidws  a  masterly  y;ras]i  of  the  wiiole  cause  and 
root  of  the  ('isorijanisation,  and  is  of  pecuHar 
interest  lioth  as  a  stud_\' of  lier  <::ra] 'hie.  vivid,  and 
coneise  itkhIc  of  expression  and  o:  her  iiientd" 
keenness.  It  is  indeeil  a  "terrible  letter,"  for  the 
truth  was  terrible.  Its  sentences  are  like  flashes 
of  !i,L;htnin,i:.  Stantnore  from  his  lihrar-  eom- 
plains  that  it  is  exa,L;,L,^erated  ..ni]  mis'  hi<'Vous, 
tlnis  ])ro\okin,u,^  the  inference  th.at  he  had  for- 
'jj  itten  to  ri'fer  to  ewn  so  much  of  '  he  official  testi- 
mony as  .\iiss  Xi,L;htin,L,^ale  quotes  ir.  the  News. 
One  of  its  o})enin,;^f  ])aratjraphs  sets  :"orth  very 
strikiti.udy  the  n^oral  c(jwardice  and  supineness  of 
the  men  in  chart/e: 


TIic  Coininissii  >ii  has  il'ine  nothing.  .  .  .  Cuir.- 
miiiL:  lias  (ji-ne  mthintr.  Ldrd  William  i'aulet  'las 
(I'lie  iii  tliin.Lr.  hiifd  Stratfiinl,  absorbed  in  politics, 
(I'H-s  in't  know  tlie  circumstances.  Lord  William 
I'aulet  kiiiiws  tliem  but  partially.  Mcnzics  knows 
tlicTii  aiii'  will  not  tell  them.  Wretord  knows  them 
and  is  stuiu'tu'd.  Tb.e  medital  officers,  if  thev  were 
to  betray  them,  would  have  it  reported  j)crsonalIv 
and  profrssionally  to  their  (dis)advanta^a\  .   .    . 

.  .  .  \'<<u  will  ;;iy  that  I  oULdit  to  have  rci)orted 
these  tliinj,'S  before.  Hut  I  did  not  wish  to  bo  made 
a  si)y.  I  tliou,i:ht  it  Ixtter  if  the  reniedv  could  be 
brouj,dit  quietly,  and   I   th.ou-ht  tlie  ConU'^jsion  was 

'  Mt))ioirs  oj  Sidney  ILrhcrt,  \ul.  i.,  jip.  393-396. 


Miss  Nighlin<(alt   and  Crimean  War  i  (7 


to  hrinj;  it.      Hut   matters  arc  worse  than  tliey  uvre 
two  months  aj^'o.      .      .      .  ' 

After  the  war  was  over  and  Mis  Xi-iitin,t,Miu 
had  returned  to  Englanl  the  question  of  how  1,, 
remedy  the  evils  of  \\hieh  she  had  beeome  cogni- 
sant absorbed  her  mind  and  energy  for  a  long 
time.  She  took  a  keen  interest  in  the  appoint- 
ment ot  the  Royal  C"mmissioii  to  in\-estigate  the 
Sanitary  State  of  the  Ar:iiy,  of  which,  Sidnev 
Herbert  v.-as  apjiointerl  chairman,  and,  perceiving 
well  that  powerful  inter- sts  wotild  cndcaxfnir  to 
■!elay  and  mutilate  the  Coninv  sioncrs'  findings, 
she  urged  Sidney  HerlR:  not  toaccxpt  the  chair- 
manship w-'hout  receiving  a  delinite  pledge  that 
the  recommc-ndations  of  the  CoTi,nii>sion  should  b^.' 
acted  upon.      She  wrote  to  hini: 

Ail  tliat  Lord  V  nmire  has  hitherto  done  (and  it 
IS  just  six  months  sine.-  I  ,  aim-  li(inu>)  has  been  to 
.i:ai!i  time,  .ind  this  Coniniissi<>ii.  I  '-ild  it,  <;ranting 
it  "Illy  as  lie  d(ns  mnc,  is  also  mireh^   to  train  time. 

lie  has  broken  }-■>  ni-ist  soU'inn  iiromises  to  Dr. 
Sutherland,  to  me.  and  to  ilie  Crimean  Commission, 
and  three  months  from  this  da',-  I  j)ublish  my  ex- 
perience of  the  Crimean  eampai^n,  and  my  sugges- 
tions for  improvement,  unless  there  has  been  a  fair 
and  tangible  pledi^e  bv  tli.it  time  for  reforTu.- 

In  this  connection  it  is  of  interest  to  note  Queen 
\'ictoria's  comment  on  Miss  Xighting.ile,  after  the 
^var,  in  a  personal  ktti  r  to  the  Duke  (U"  Cambridge: 


'  Mcwoirs.  vi 
•  Ibid.,  \-c]    11 


'•■  P-   ,193 


148 


A  I  lis  tor}'  of  XursiiiL;- 


w 


Have    iiKnle 


M 


ISS 


Xi 


i,L:lUin,i'ali'  s    ;af|uaintanc(' 


[slic  wi-Mtrj  and  arr  deli-lite^!  an<l  \-rr\-  nnu'li  striuk 
]>v  !uT  ,t,'rcat  .i,antlc'iicss  and  sini]  ilii  it  y,  and  Wdndcr- 
tul.  (liar,  and  tMinpixhcnbiw   ln.ad.      I  wish  \vc  had 


ral  the  War  (Jflicc. 

W'v  n-turn  now  to  Scutari,  where  tl 


service  ex])erience(i  one  of  the  haphazard  inetl 


le  inirsin<: 


lods 


of  the  War  '  )ii !e 


e.      It  had  hem  arran'^tnl  for  that 


reiiitoreemeiits   of   nursis   should    be   sent   out   il 


needed 

)h 


l)Ul    onlv  on    .Miss     Xi'dit 


muale  s 


auto- 


rapli  refiuest. 


1 


Tlie  Lad\-  \'olunteer  writ 


es  oi 


the  later  nursintr  slat'f 


T 


U'ir  sekH-tion  was  left  in  the  hands  of  Mrs.  vSid 


nev 


Herbert,    .Miss   .Stank 


sisti'r  (if   Dean   Stanley,   aiii' 
iss  Jones,  Superintendent  i>{  St.  John's  House.     A.- 


a  test  of  (]ualilieati'ins  of  the  ajiplieants,  it  was  a.ijrei'd 
that,  with  few  exceptions,  all  should  s^'o  through 
trainin.i,'  at  soine  of  tlic^  London  liospitals.  and  to 
facilitate  this,  S;  Jolm's  Iloii-e  and  St.  Saviour's 
home    were    ojieiicd     to     rccei\e     jirobationers,    anil 


lat 


eriv 


th.ird 


institution    was   establisiied    for   tlu 


same    purpose    under   the    jiatrona.i^e   of   the    Earl   (f 
Shaftesbury.' 

In  some  unexplained   way,   a  second  party  of 


fortv- 


six  was  sent  out  in  charge  of  Misu  Stanley 


in  December,  i8^;,  not  onlv  without  .Miss  Nieht- 
in.c;alc's  " autoj^rnipli  request,"  but  even  without 
her  knowled,<,'e,  until  thev  were  on  the  way.      Rut 


ri 


IT  own    worils    in 


.  C/|'.5     oil     tl!'' 


Br 


sh    Ar 


shiiwini,'    Stanniore    tii    he    i 
ini.  iiifiil . 

-  (  'p^  (  ;'.'  .  \c)l    i.,  \>\}.  I)    10. 


'.^4, 


n.iccurate   in   his   account  of  thi 


-Miss  Nightingale  and  Crimean  War  149 


lliis  was  not  all.      X( 


spatchcd  witliouL  iiiuuirii 


It  "nl\-  Were  th 


(•   nurses  df- 


uartcrt' 


juiriiiL;  uhetluT  thc\-  cnul.l 


md 


ISsiinK'i]    tn  (lilt 


the    hi  under,    th<'V    were 


y,  lull,  U>  complete 


consi'j-ne( 


niiiiLj  (will 


to    Dr.   C 


um 


Av)\\\  was  li\ 
Iv-in-Chi 


IS  inan\-  uidieations  would   appear  t( 


no  means  friendh 


and  lU't  to  the 


I. ,11 


It  is  unnecessary  t( 


I  liaracter  of  this  ] 


point  oiii  the  uns\stemat 


ic 


)roceedutL;,  and.  reniemberinu  the 


regular  correspondence  In'tween  .Miss  .\i-luin-,rale 
;<nd    Mr.     Herhcrt,    it    seems    (juite    incxplieahlc 
"niess   it    v.as  that   the   pn)blenis  ..f  the   nursintj 
department   were  lost  in   the  titanu-  j.roiK.rtions 
"f  the  .!.,\'neral  mismanai!:ement. 

\o  OIK'  at  this  distance'  can  estimate  jmiperly 
the  -lant^^TS  and  dinicu!ti(-s  surnmndin-  Miss 
Xiiihtin-alo  and  her  nurses  in  this  at  that  time 
new  and  untried  position,  nor  mav  it  be  won- 
dered at  that  this  action  disturbed  and  an- 
noyed her. 

As  Miss  Xi-htino;ale's  own  story  of  those  (kiys 
has  never  been  told,  nor  her  letters  published,  the 
I'-W  extracts  from  them  presented  with  carp- 
in-  criticism  by  Sidney  Herbert's  bio-rapher  in 
'■>!ation  to  this  incident  cannot  be  "considered 
.-  affordin.^:  definite  or  hnal  information,  nor, 
u-ithout  the  ability  to  show  her  side  of  the  .storyi 
does  it  even  seem  \vorth  while  to  discuss  them. 

Ahss    Stanley    and    lirr    nurses    were    halted    at 
i'l'Tapia,    puzzled    enou.^h    at    the   delay.     They 

'  Memoirs  oj  Sidney  llcrhfri.  vut  i  ,  p,  372. 


>o 


A  Ili.->tory  of  Nursing 


wi'ix-  told  lo  take  up  tlu'ir  al » n\c  in  an  cmptN'  liouse, 
uir  h,  hi  >\\(.'\i'i-,  .Miss  Slaiik'V  sucx-ffik-il,  In't'iirc 
ni.^htlaH,  in  furnishing:.  Il  had  been  hvv  intention 
t"  iTlurn  inun.'i  liatrly  in  Ew^lun]  after  landin.ij; 
the  nui-se^,,  hut  new,  st'eini,^  that  (lifficuhies  were 
Itehire  theni.  shie  deeideil  to  reniaii with  tllem, 
'I'hrc'e  (kiws  afterward  sh.-  \\ei;t  to  Seutari  tn 
see  Mi<s  XiLiIit  ini^ak',  whom  she  writi'S  of  as 
'■  d,ear  I-di  I." 

I  '.vent  thn.u.^h  a  duor  [slie  wr^te  hMjii(d.  and  there 
sat  ik'ar  Vln  wriiini,'  nn  a  small  uiipaintid  deal  tahlc. 
I  ncv.-r  saw  her  liii.kint;  luttcr.  She  had  mi  lier 
blaek  merino,  ..ri'iinied  \'.  hli  hlaek  \ei\et.  dean  linen 
collar  and  euffs,  apron,  -.vliue  rap  with  a  hlaek  hand- 
kerchief tied  over  it.  ...  I  was  (juile  satislieJ  with 
my  wileonie.   .    .  .  ' 

.\l;hou,L;h  Mi.-^s  Stank')-  tlicn  ]<  ann'd  thewlinle 
state  ot  tiling--,  it  has  not  ln'cii  in.iile  known  to 
the  ]iuk!io.  Her  letter  diows  ] jerj ik.xit v  and  eon- 
ceiai.  The  infereiiee  i-;  i  lear  tliat,  in  order  to 
resist  the  und.erniinin<j;  of  lur  Ici^dtimate  anthnritv, 
aiuk  possihly,  to  (Xjiose  intriL,'Ue,  Miss  Xii^htine^jale 
\v;is  f(.'ark's.s  cnou.Lih  to  dei  lare  her  detenninali'ii 
to  resi,v:n  rather  than  remain  under  eon.jitiiins 
wltieh  would  feller  her. 

ddie  crisis  passtd.  Si(hiey  llerhcrt  wouM  ni>t 
hear  of  re.sijxnation ;  k'vally  (and  jiroperlvi  took 
U])()n  himself  the  bhime  of  the  unannounced  parlv 
of  nurses,  and  after  a  month's  delay  they  were 
distributed  amon^  the  various  hospitals. 


M. 


iHoirv,  \(il    I 


Miss  Xightini^^alc  and  Crimean  \\'ar  151 


Miss  Stanley  nmaiiu'd  wiili  Ihcin  for  six 
nioinlis.  ami,  lh')u,i;h(if(lrlicaU'  health  aii^l  withnnt 
any  fxperirncc  ia  nursinL,^,  ^aw  iin-ahial)k-  scrx  icr 
in  supep-isinij  and  thapfninin;^'  tiicni,  and  in  ovct- 
I'lmiiv^  pivju(hc(.'  and  (ipp)sitii)n. 

This  second  parly  'lonsistcd  of  flftivn  Ronutn 
C.itholic  nuns,  nine  Iad_\-  NohinteiTs,  and  twenty- 
rvo  nurses.  Miss  Xi-htin,<:aK>  h.is  left  the  fol- 
I'win.L,'   alhision    to    the    nursing-    staff. 

It  ft  he  fiart}-]  was  f' .If, wed  by  nunicnms  additions 
durin,L:the  _\-car  i.s-.;,  ai.d  the  female  inirsin,!.:  cstah- 
lishmcnl  was  only  .)rnken  up  witli  the  rt'iurn  of  the 
arm\-  in  July  iS^o,  tlie  Superintendent  lei  \-in;'-  finall\- 
on  July  28,  185:1.  Durin.^  this  perioci  a  -reat  niiniher 
had  returned  home  from  siekness  and  other  eauses. 
.Vine  (hod.' 

1  hat  thie  ri'sj)f)nsihilit\-  of  tlie  nursing  staff  -w.is 
.1  hea\-y  one  may  he  K'.irned  fn.ni  the  Lady  \'ohin- 
ti'er,  wlio  writt's  on  this  pi»iiu: 

There  was  ^nc  <,'reat  trouMe  wda\  h  \\e  iieiMn  to 
t  el  ;ii  this  time  -naiaelv,  the  eonduel  (.f  the  hired 
nurses.  We  h.-id  jn.iee.l  heen  tried  hy  tlii.s  fn.ni 
die  hi'-^inninK,  and  se\eral.  as  1  !ia\f  nicntionecl,  were 
s.-ni  home  for  had  eomhict  .  hut  siill  tiie  distres.s 
>e-ound  th.ein  and  ti.e  frei|u<nt  sitkiie-,s  anion;.;  th.eir 
own  numbers  kept  .some  .sot  ef  eheek  anion.u  them, 
iind  after  some  had  been  disint.ssed  for  bad  conduet. 
and  others  from  siekncss,  (inly  two  remainec]  wjun 
the  new  party   arrived  oti  April  (,tli. 

^hss    St.mlcv's 


Tht     Iiospital    eostume    in 


,.'.a. 


1  .W'hs  OH  the  liruish  Army,  ji.  155. 


'  5  -  A  1 1  i  h to r \  (3 f  \  u  r^  i  1 1  <  •• 


art\-    Irft 


.unl    wa'^    wcrn    alike    I)\-    la'l 


i(\s   ami 


nurses,    wliirh    was   iiUfinUMl    f.    mark    ili 


ciiiiaiit ' 


svstc:ii,   but    SI  "ill   after  I 


fnund   it 

(ircss  as  t 

The  1 

nifort 


x'^'iiiniii^'   hospital    v  >  rk    \\< 


"   continue    wearniv 


lie    sanie 


le  nur>es,  aiiil  iheretMrc  (ii> 


illtllUk 


:t. 


aiiK 


s   s     'U    fnuii'l    it    necessar\-    fur  tliei 


r  '  i\\u 


i'(» 


and  1' 


the 


it  tl^cir  \V(irk  tliat  in  eve 


rv 


l)(i.>sil)le  ua\-  the  distinction  should  he  draw 


n. 


X 


I  me 


I>ut    tl 


lose    u  li' 


k 


new    it     lan    iniai'ine    th 


e    wearinj,' 


anxietv  and 


I'  liitter  hunnhatii.n  tlie  eliarj^'e  ot'  the 
hired  iiuises  brou^'hl  uj.or.  us.  lor  it  should  he  re- 
iiiernlnred  that  we  stf^.d  as  a  small  hody  of  I':nj,'lisii 
Women  in  a  l'.rei,i,'n  country,  .-md  th.it  we  were  so  far 
a  cominunn\-  that  ;he  act  of  one  disjjraecd  all 
On  April  the  jist.  a  second  party  of  three  ladies  and 
se\en   luirses   ioined   us. 

A  lew  weeks  oniv  iiad  elapsed  since  the  departure 
of  the  two  Women  I  iuive  mentioned,  when  disj^raioful 
misconduct  caused  the  dismissal  of  a  third.  Kre  a 
passage  could  he  had  for  her  another  was  obliged  to 
go.  from  her  ha''its  of  int..\ication,  and  sli<'  had  been 
one  most  highly  recommended.   .   .   . 

Our  trials  were  not  ended.  A  similar  case  of  had 
londuet   I  hliged   tile  disuiissa!  of  one  whom  we  had 


lo.iked 


>v   as   one   of    our   best    nurses. 


Inuther 


was  t   und  i>ito.xicated  in  the  wards;  these  two  went; 


atn 


till. 


>ut    of    twenty-one,   in   less  tiian   eight 


iiiMiuiis  we  h  id  eleven  left.  To  our  profound  aston- 
ishment ue  f.  aiiid  ;h.it  i.ui-  sending  home  so  many 
gave  great  umbrage  to  the  authorities.  .  .  .  They 
thought  lit  to  send  a  reproof,  demanding  more  par- 
ticul, 
Th 


irs  () 


f  th 


e  rases. 


ev    were 


respectfully  reminded   that   our  si 


f)er- 


intcndtnt's  duties  did  not  include  tlK  reformation  of 


.^ 


.«-^, 


I 


} 


4^ 


XF  ■ 


-J 


".^.lircy  Gaiiip  ' 
A  !iur»    ..(  sixty  )i.irsat;i> 

i  .r„,!..i.,„  ,„,„  \V,I|c..,r..'./V./„.,v..,./,Vr«-,  /V,..,.    I!,.,,,.,.,,...  Wrllc.n 

C",.  1907-  ( 


Miss  Xiglitingalc  and  Crimean  War  15;, 

women  (if  loose  (  ha, actor  and  immoral  habits,  noi 
did  we  imagine  tlu  authorities  would  require  details 
which  were  otten  t-o  terrible  to  dwell  on. 

Of  the  remaining  inne  two  were  very  unsatisfactory. 

Six  were  respectful  and  in<1ustrious,  aiici  under  a 
lady's  supervision  did  very  well,  but  n-t  a  single  one 
except  Mrs.   W'ot.dward  e<iuld  be  tru-ted  alone. 

The  light  (-.ndu.-t  of  another  of  the  hired  nu'-scs, 
e-L-n  at  this  time  of  distress,  obliged  her  dismissal. 

.  .  .  After  some  day.=  she  recv  .-cred,  was  sent  home, 
and  I  believe  is  now   ^  nurse  in  a  London  hospital.' 

What  with  the  ine.xiKTience  (,i  the  lach'cs  and 
the  unreliabihty  < 'I  the  jKiid  nurses,  the  inirsing 
was  chiefly  confided  to  the  hai.ds  of  the  SistiTS  of 
Mercy,  whose  rigoroit:;  training  stood  them  in 
good  stead,  atid  whose  talents  for  svstem  ,.nd 
management  were  of  juninary  importance.  Tlu  y 
were  indrfatigably  seconded  bv  tlie  ladv  volun- 
teers, and  bore  the  brunt  of  diffieulties  in  tlu' 
funeral  hospital  of  Scut; -i,  and  in  that  at 
Koulaloo,  whose  lady  superintendcni,  after  .Mis^ 
Stanley  left,  was  Miss  I-:mily  I  hit  ton  ' 
hospital    canu'    to 


lie   considered    a    model 


s 
;  nis 
The 


\'olunteer  writes: 


Motl 


ler 


f'lur  Sisters,  t  v.   ■   lat'-es.  and 


t\>  o 


nurses  to  assist  her.  She  h;id  Juug  e.xiieruiice  m 
liosy)ital  work,  and  j  os.sesscd  a  skill  ,ind  judgment  in 
nursing  attained  bv  few.  Tins  hospital  fmm  lirst 
to  last  was  adniirabl\  manai,'rd.  When  the  means 
impro\-einent  were  plaee-j  in  her  hands,  thfv  were 


'Op.  lit  ,   Vol     ij  ,   pj),    r  ;-2o. 


•54 


A  History  of  NLirsin'' 


jii'liiif)usly  u'^c'!.  ami  tlio  lios-'ital 


inilTiAXM]   that 


liccamc  tlu'  aMiniralmn  of  all  who  \-isitc:l  it, 


I'ridf  ( if  the  ladies  an 


(1  mirsfs  \\iio  wor 


ked 


and  tiic 
in  it ;  wc 


used  to  call  it    ■  the  ni'MJel  hospital  of  the  Kast." 

Miss  .\i,i;htin.y;alo  li;is  left  elM(]iient  and  lioartfe 
trihtites   to   the   vSislirs,    for   manv   of   wIk 
entertained  affectii-n  and   rei/anl. 


)m   she 


The 


:irniy  <  mlerlies.  as  e\ery  nttrse  mav  ima^n 


ne, 


were  at  first  a  most  trvini/  cl 


iSS, 


)Ut  ih 


to    ha\-e    dexelopeil    under    the    inlltieil 


t'V  aj)pcai 
f    the 


ee    ( ) 


laihes,  better  than  the  ])aiil  ntir: 


ses. 


Miss  Xi"ht 


111- 


ale  inspired 


Ih 


em, 


as   she  did 


th 


e  soMuTS,  With 


a  chi\-alrons  deN'ofion,  and  tlnTe  were  no  iKnind: 
to  the  ser\ices  they  world  chj  for  Iter.  She  her 
seh'  said  of  them  : 


And  here,  hoinelv  and   si^d< 


-nin^q;  as  is  the  siihjret 
re\-()ltin,t:   daties   that 


inipelleil  to  reqiiire  liuni  t'l  perf 


orin, 


[sh(>    had    lieen    desoriliin^'   {'hv 
she  h.ad  been  C( 

aii.i.  indeed,  to  assist  them  in],  I  must  pav  my  tribute 
t'l  tlie  instincti\-c  dclieaey,  iho  nadv  attentir.n  of  or- 
derlies and    patitiits  duriny  all   tliat   dreadful  peri' ^1 ; 
t'lr  my  sake,  the\-  ptrformiM]  olfices  of  this  kind  whi'li 
they  neither  would  for  the  sake  of  diseipl.ne.  nor  f^r 
that    of    the    iinportan<'e    of    thiir    own    health. 
And   ne\-er   one   wird    nor  nuc   h- ,k   wiiiih   a  .Lreiitle- 
man    would    n..i    h,i\-e    usci.    and    while    ji.avinj,'   this 
humble  tribute  to   humble  e,,urtes\-,   the  tears  come 
int.'  my  eves,  as  I  think  how,  amidst  seencs  of  horrible 
'illli.    ot    I'.aths'ime   disease    aii'l    death.,    there    arose 
above  it  all  the  innate  dignity,  j.,'ent!enes;-,  and  chivairv 
of  the  men  (for  nc\er,  surely,  was  chivalry  so  strikintrlv 
fXwmi  hfied)  shining'  in  the  midst  of  what  must  be 


Miss  Nightingale  and  Crimean  \\'ar  155 


iisiilcrcd  as  ilu'  lowest  sinks  (jf  1 
ircwnt  in.L:,    insiiiu-ti\ily,    the    use   of 
vhiv'h    I'liuld    ilislrcss   a    <'cnt Ii-woman  ' 


ninian  miscr\-,  a 


nd 


I 'DC   cxpi  L'ssmn 


In  till'  tit  her  hospitals  the  same  w 


IS  sail  I 


Thi 


1.,:  I\-  X'liluiUixT  wrol 


e; 


Without    tl 


ftl 


ie  (ir< 


Icrl 


le: 


H'lr   [th 
\\t  rr  a 


c   ladies']  superintendence,   tl 


n  i<ll 


c,  useli.'SS  set 


men,  cal 


ley 

'US 


Vi  the  sulTiTiiT'  I'f  tln'Sc  ar'iui 


id  t 


:m.  Hot  trvinj/  to 


learn  their  l)U-;iness,  which  was  of  course  new  to  theui 
and   re,c;ardless  of  carryinij  out    the   doctor's  orders, 
wiien  they  could  do  so  v,ith<.ut  ^ettins;  into  dist^'rai'c; 
Init  under  the  Sisters'  and  ladies'  hands  thev  liecanie 


an 


excellent  set  of  nurses. 


f.  -rn 


lilt'  t  liat  cla^ 


if  ni 


en- 


trou- 


nurses  of  course  essential  in  a  niililarv  hospita' 

.   .  .   The  ordi-rlies  at   Halacla\-a  had  been  a 

lilesonie     set,     uiKH'custonu'd    to      ha' its     of     ( 1,  aii 

liness  and,   order;  ri  f^rnis  were  no\'.-  introdm-ed   am 


ca 


rrie(l 


out;  encouraL;einent  from  the  Sisters 


and  t  iieir 


L'entle  manners  ilid  much  more  yood  in  teachinL'  tl 


le 


lerlies  than  all   the 


Maine 


thc\- 


li.ad  jjre\' 


sh 


re- 


ceived. Just  at  this  time,  the  corps  of  ci\il  onlerlics, 
reported  to  be  already  traine<l  to  undertake  nursing.', 
arrived  from   l-"m;l.ind.     They  Landed  at  Scutari  and 

the    o(]kt    hospitals. 


re    soon     dispersed 


anioiiL' 


1  nev 


all   w 


ore  a  unitorni  dress  of  Miu-  snioi-ks. 


am 


\ver     ])ronouiu 
huttners." 


>\-    the    s 


ii  111  hers 


to     I 


le 


a    set    of 


1^6 


A  Ilistors'  of  Xursiiii 


others  ],u\  to  which  wc  cnn  -nily  make-  the  lirirfcst 
rc'tcTcnrr:  die  curv  ><l  the  wiws  who  had  i'mHdw,,] 
their  husbands,  and  <<i  the  little  new-born  cliild- 
reii:  th.e  establishment  of  readini^-rooms,  amnse- 
mints  and  leetures  for  the  me!i ;  of  a  cafe  at 
Inkernian  to  ilraw  the  nieii  awav  from  the  can- 
trcn;  (,t  the  enormous  ])ersona!ly  conducted 
corresi)oiidi.iK-e  with  the  wiws  and  families  at 
home,  and  ol  the  extemporised  mone\'  order  ofTire 
m  her  rooms  at  Si.utari,  where  she  to<ik  in  the 
men's  ])ay  for  transi-nission  home,  sending,'  thus 
to  the  families  in  l-hi^^dand  about  /jiooo  ewrv 
month.  This  work  of  hers  was  later  taken  over 
b\"   the  ,i;o\Trnment. 

In  .Ma_\-  Miss  Xi.L^htin.irale  made  a  tour  of  in- 
spection of  the  hospit.ils  of  Balaclava,  and'  whi'e 
there  suffereci  ;,i]  .ante  a,tta(d<  of  Crimean  feM^r. 
She  was  nurse<l  thn^i.L^h  it  by  Mrs.  Roberts  and 
returned  to  Scutari,  weak  but  undiscoura>.,'ed, 
aK-,t  a  month  id'ivr  leaving'  it.  The  many  in- 
tensely interesting:  details  of  lu-r  tours  amon,t,'  the 
hos;)itals.  of  vdiieli  a  number  are  related  bv  Sover, 
her  lat<T  return  there  and  her  life  in  the  little  hut, 
while  superinti-ndin.i:  tlie  arran,L,'ements  of  the 
armv  of  oeeupali.  .ti,  as  Well  as  th"  later  events  in 
the  hospitals  at  Seutan,  must  be  passed  o\er, 
and  the  riMder  referred  to  the  pai^es  of  her 
bioj^rraphies. 

We   sl-.all    now  quote    from    Miss    Xic^htingale's 

own  summary  of  the  work  o|    the  nursint^^  staff: 

.   .  .   Uuaners  and    rations  were  assi'med   te)  ihein 


'f^.r 


^wi* 


Mi-  Ni-htirigalt'.^  Carriage 
iu  c-x,ra..r  linary  cv.n,,,,,.  Mi.,  Ni;^l„i„^alc  im,....„i   u|,o„  herself  a<  .r 

■U  Ihw  carriaj^c  uouKI  have  ;  -cm  perfectly   n.creiiM..  if  n,,t   uitnewd  I,v 
I  lan  vouch  for  the  laet,  having  ficiuently  accomimiHe.l  Iter  to  the  h.„|,i 

well  as  to  the  in„„aMery.  The  re-urn  from  thc.e  ,,lace>at  t.i.l,,  „  ,,  ,  ,,„. 
■  -IS  .xpermieiit,  n.  th.-  roa.l  Icl  :urn.,  a  ^crv  uneven  coniilrvr  It  u  ,.  -,  'i 
■il-.w  when  sn  ,vv  was  upon  the  ^r,.,„,|.  j  i,.„e  ,,.^„  ,i,at']a,lv  si  u..l  f,,r 
•  H  i.ipof  a  1,'cak  rocky  mountain  near  the  hospitals,  j^.vi,-  her  in.ir, 
ule  the  s„„w  ua.  faHint;  heavily.  All  one  cou|,|  .av  to  !„  ,  ?.,  thesul^e^  t 
^"■llvrecc.ve.l.  t!KUyoucon<ln,K.,i  von  IkvI   p,,-n,,Je;    I,.,-  ,,,  ,,,ke  .no,- 

herself.      \  a  she  alvv  ays  u  rnt  .  n  Im   li.e.;,,nc   wm.    I,,u:i, 

"  '<i  alvi,  e  ;n  her  anvicly  t.  r  the  cmfnrt  ..f  the  sick. 
"'  n  uarne-l  her  of  the  <lan^'er  she-  incu-re.l  in  retnrnin- 

•  ■•ther  tscort  ;han  the  driver.      She  answer 

"u  may  I,e  ri-ht,  l,nt  I  have  faitl,.--_>,  .y,  k,  ..«.  ,,/.  p,,,    ,,,,   ,„^ 


•bablv  f.  r- 


late  at  ni^l,!. 
'1  hy  a  smile.  uhiJi  secnied  l» 


Miss  Xiglnin-alc  and  Crimean  Wa 


r  '57 


witn.n    the    Harra.k    h,,s;,i,al,    at    Scutari.  .  and 

Miss  .\.-htinKaIe  was  furnislird  with  InstriKti.ms 

It  was  not  until  March,  ,,s,-r,,  that  Mirs  .\i..l.,,i„,,  ,i^. 
v,as  put  indiviriuall>  int.  Tn.ncral  Orders  '^  lUn  un 
'..-ncral  Order  has  ever  exis.v.l  defining  the  duti,  . 
-t  the  nurses,  in  the  vari.uis  hospitals  to  which  they 
v.(  :c  rcspecti\-cly  attached. 

This  will  in(li(  le  how  ill-dcfincl  the  positmn 
"i  the  nurses  was,  and  how  eas,lv  their  onlrol 
an'l  (HscipHnc  mi.t^dit  have  l.een  ustirpcd  l,v  the 
ni.htary  oilleials  ha.l  not  .M,ss  Xi-htin-ale' been 
strnn-  and  able  enough  to  insist  on  retainin-  her 
I)"\ver. 


hi  the  civil  hospitals  of  S 


nn 


number  was  hxed  before  1 


rna  and  Renkioi   t 


le 


that  of  tliose   servi 


eaxinj,;  home,  toi,a'ther 


WItll 


rc-ard  to  Abss  Xi.t^dn 
aiaiuted    into    the    II 


n^   in   ot:,-r  (U'parlment 


s. 


Wit 


mi^'ale  s  nrst  part  v.  tiie 


1 
number 


Siutari,  was  fixed  bv  an 
r:inci]jal  medical  offici.T  o 


irrack    an.l    General    hospitals 


an.t^'cini'iit  with  the  i 


th. 


se  Iiiispiial 


espective 


i!l\ 


Hut, 
ision  depended   ujjon   the  medical 


neverthjless,  the  number  adnutted  into  each 


n'.'.ision,   wh( 


re! 


sometimes  accei)ted   t! 


it'ticer  of  that 
lein,   sometimes 


m   after   th 


used   them,   sometimes  acccjited   the 
d  been  refused ;  while  the  d 
'erform  varied  accordinp;  to  the  will   of'  c 


C\' 


uties  they  were  permitted 


1  vidua!   nieoical   oft 


acn  m- 


icer,   and  eat! 


anil  accordin.s,^  to  the  a 


1   one  successi\ 


el\- 


'■fliccrs  and  orderlies,  an< 


mount  of  occupation  of 


medical 


11   n    in    v.-hich 


each    individual    n 


according,'  to    the    estim; 


each  in<li\-idual  medical  ,,*] 


urse    was   held    1 


iccr. 


With 


res. 


ard  to  extra  diets,  nice 


lical  comforts 


'JV 


and 


MICROCOPY    RESOLUTION    TEST    CHART 

ANSI  and  ISO  TEST  CHART  No    2 


1.0    Iriia  IM 


I.I 


1.25 


^1^ 

2.2 

2.0 

1.8 

1.4 

1.6 

_: -^ 

= 

^     /IPPLIED  IN/MGE     Inc 


•■f,',\    [ .)«)    »^<r,    <~icA*< 


i5« 


A  History  ui'  \ur>']n-j^ 


"  iv  ,!:;if;s"  iritliini;  v.as  L'ivcn  l)y  llie  mirscs,  cxceiit 
l)y  die  onltT  nf  i!ie  sui'iTintcii'lont,  wIu'l-Ii  nnler  was 
c-Dnscquent  U]"i!i  tlio  rfquisitinn  (if  a  niidical  dtlRcr 
ami  that  only,  with  sonic  few  excepti()n>. 

The  princijile  introduced  by  Dr.  Meyer  in  the  ei-  il 
hospital  at  Smyrna  and  altcrwards  carried  out  in 
that  of  Renkioi — was,  that  a  certain  number  of  ladies 
should  have  the  superintendence  of  a  certain  num- 
ber of  paid  nurses.  This  did  not  interfere  with  the 
action  of  the  male  orderlies,  except  liy  reducing,'  thci- 
labour  and  ihi'ir  mniduT.  In  each  case  the  females 
were  distinctly  under  the  direction  of  the  medical 
officers  and  had  nK^re  or  less  char^^'c  of  the  extra 
diets.   ... 

Immediately  upon  the  arrival  of  the  nurses  at 
Scutari  in  Xovcmber,  extra  diets  were  prepared  by 
them  for  the  patients,  in  the  stoves  which  they  had 
brMuudit  v.itii  tlicm.  ...  In  the  Crimea,  extra-diet 
kitcliens  were  or<,'anised  in  the  (ieneral  hospital, 
in  February,  1S55;  and  at  the  Castle  hospital,  Bala- 
clava, in  .April  1.S55:  /.(•.  as  soon  as  female  attendance 
was  incoriiorated  into  each  rcspecti\(  Iv.   .   .   . 

.\  portion  of  the  materials  for  the  extra  diets  at 
the  Barrack  hospital.  Scutari,  and  also  in  the  Crimea, 
was  found  by  Miss  Xi.i,ditin},'ale's  funds;  on  some  oc- 
casions because  the  sujiplies  in  the  purveyor's  store 
had  run  short;  on  others,  because  they  were  of  bad 
quality;  on  others,  apain.  because  the  purveyor  de- 
clined to  furnish  the  articles  of  food  (although  on 
the  diet  rolls  of  h(>  medical  officers),  which  Miss 
N'iK'htinKale  then  i>urchased  in  the  open  market. 

The  second  purveyor-in-chief,  in  May,  1855,  placed 
the  whole  of  the  li'cn  and  small  stores  for  the  wards, 
arranged  under  divisions,  under  the  care  of  the  nurses 


Miss  Xi-htingalc  aiu 


1  Crimean  War  159 


as  far  as  rc.sjjar.lcd  the  Barrack  hnspital,  Scutari.  In 
XnvcinlKT,  1855,  they  assumed  the  same  charge,  on  a 
snmewliat  different  f.K.tin-,  i„  Uw  General  hospital; 
but  in  the  Crimea  it  was  arrano;ed  tliat  tlie  mass  ..f 
linen  should  be  sent  down  to  Scutari  to  be  washed. 
Where  women  form  i>art  of  a  hospital  estal)lishment 
the  charge  of  the  linen  slmuh!  evidently  devolve  upon 
them. 

In  conclusion,  it  should  be  recorded  that  the  three 
periods    when    the     Female    Department    gave    the 
greatest  proofs  of  their  utility  were:  first,  on  the  arrival 
of  the  woun-lcd    from    Inkerman.   at    S,  uiari,   Nov. 
i).  1 854,  and  during  the  subsecjuent  UKjnths  when  the 
army  sufTered  most  from  sickness  up  to  April  1855. 
A;icr  that  time,  a  great  many  otTu  iajs  of  oery  de- 
partment  were  added  to  the  hospitals  at  Scutari,  a 
great  decrease  .)f  sick  and  wounded  took  place  there, 
:n::  lo  the  impr.Aed  lualth   of  the  army  and  the 
'ievel.jpnient  of  hospitals  in   tlieCrmu'a,  and  a  eon- 
si. ierable  accession  of  stores  had  arrived.     The  seermd 
I'lriod  of  their  usefulness  was  during  the  heavy  sum- 
:v;rr  work  of  nursing  the  wounded  in  the  Castle  hos- 
I'ilal.   Balaclava,    1S55,   and   the   third,   wh.n,   in   the 
si.ring   of    ,856.    in    conse<iuencc    of    great    sickness 
aniong  the  Land  Transport  Corps,  there  was  a  press- 
nr.'   upon    the   two  general   hospitals   for  that  corps 
•■rganised  near  Karani  in  the  Crimea  by  the  excellent 
!'"incii)al  .Medical  Otriecr,  Dr.  Tavlor. 

Vny  one  who  ha.s  well  C(jnsi{Ierc(l  the  subject  of 
nurses  and  hospitals  .  .  .  will  probably  come  to  the 
'  I'lulusion  that,  when  the  nursing  is  applied  not  to 
•ivil  but  to  military  hospitals,  the  mode  of  nursing 
i'V  orderlies,  who  pcrfomi  also  the  drudgery  of  hospital 
servants,  should  by  no  means  be  done  away  with. 


i6o 


A  Hi 


C) 


f  X 


ursmir 


Tt)  lake  aiinhin,!:::  from  the  authoritv  of  the  medical 
ottkers,  or  to  reduce  their  responsibihty,  would  never 
be  eonteni|ilated  In'  any  one  con  dneed  of  the  para- 
mount inipurtance  of  the  promptitude  of  action 
resultini;  fmin  unity  of  ,<;overnn)ent.  It  remains, 
therefore,  that  female  nursing,  while  eiuirelv  suh- 
ordinated  to  the  meiHcal  autlfriiy,  should  not  he 
charged  with  the  nure  drud.L^ery  in  the  necessarv 
cleansing  and  lahnur  i>f  a  n.iilitary  hosjntal,  but 
should  be  made  eajiable  of  iierfomiing  what  may  he 
termed  "skilled"  nursing,  l)y  a  course  of  ]irevious 
instru'tion,  and  shouM  add  to  the  nii  etics  of  female 
attendance,  which  ha\  e  been  tnund  so  grateful  ]n 
the  patient  in  all  civil  hnsi>itals  and  in  domestic 
life,  a  moral  influence  whicli  h.as  n^w  ln'^n  jirovcd, 
beyond  all  doubt.  In  be  higlily  iicnelicial  to  the 
soldier. 

Although,  fmm  th.e  great  difficulties  presented  by 
the  diversity  of  i  harai  ter  "f  those  who  went  out  tir-t 
and  of  th'>se  who  subsc(jUintlv  fnlidwcd  during  tlie 
whole  n\  the  ctunjiaign,  a  stumbling  block  was  added 
to  the  many  ditfuulties  at  the  very  threshold  of  the 
undertaking,  yet  nevertheless  the  withdrawal  fr'-ni 
the  work  of  those  who,  IrMin  timi'  to  time,  showi^i 
themselves  inci)m])ctcnt,  and  the  recognised  svsteni 
of  discipline  introduced,  brought  the  i .  .rps  of  fenialj 
nurses  into  such  a  cimditinn  as  lo  enalde  them  \n 
continue  the  work  1 1n-' lUL'li' ut  the  campaign.   . 

Disciiilini'.  fnuiiiled  on  artu.d  efficiencv  in  thr 
service,  and  v^-ith-ut  respect  of  persons,  was  inune- 
diately  adoi)tcd,  and  tii'.s  necessarily  occasioned  the 
sending  home  of  those  who  proved  incompetent.  .  .  . 

A  primary  principle  of  discipline  was.  th.it  nn  in 
terference    with    the    regulation    of   the    lujspital,  i^r 


Miss  Ni-^Huingalc  and  Crimean  War  i6i 


vrith   the   legitimate   orders   of   tlie   medical   olficers, 
shoulii  take  place.   .   .   . 

Upon  the  toregiiing  principles  the  nurses  in  some 
cases  performed  la'-ger  chities,  in  assisting  the  sur- 
geons, than  in  others,  according  to  the  orders  of  tlie 
particular  medical  officer.  The  system  of  requisition 
by  a  medical  otficcr  was  also  accepted  and  acted  upon 
by  Miss  Nightingale,  who  answered  the  re(]uisiti(m  of 
surgeons,  both  for  extra  diets,  medical  comforts,  and 
necessaries. ' 

After  j)e;ico  Was  declarcl,  Miss  Xightinj^'ale 
saw  all  the  hospitals  of  the  Crimea  close-!  one  by 
one;  stopped  at  Sctitari  and  closed  the  Barrack 

hospital — with  what  emotions  one  may  imagine • 

..iid  returned  to  England,  reaching  home  in  August, 

That  Miss  Nightingale  could  hold  sucli  a  po- 
.Mlon  as  hers  in  the  Crimea  without  incurring 
enmity  is  naturally  not  to  l.'e  expected.  As  a 
matter  of  history,  she  did  encnniter  e\ery  \-ariety 
of  ;intagnnism  which  might  he  expected  to-day 
in  sucli  work,  and  another  beside,  fortunately 
less  common  now  than  then  — the  antagonism 
of  sectarian  intolerance.  In  reading  the  history 
of  social  movements  in  the  first  half  of  the  last 
'■'■ntury,  it  is  .strikingly  evident  that  doctrinal 
jealousies  and  aiiimositic'S  were  often  fat.il  ob- 
'  i"lrs  to  the  inipni\cnii>nt  of  pitiful  orevcn 
ii"cking  social  conditions,  and  it  was  with  oiil\- 

Xolrs  on  lltf  liritislt  Ar.nv.  pp.  152-16^    1  In  those  n'p..rts 
'liss  .\ii;htin;.jale  always  speaks  of  herself  in  the  Jur.i  person   1 

VuL    11— 11 


i6: 


A  History  of  Nursing 


too  much  rcv'isnn  that  Ri(hu'y  Herbert  had  stateil. 
in  a  pubhe  kiler,   that  the  hospitals  should  n'lt 
he  used  as  "the  arena  of  hostile  efforts  directed 
hy    riwal   creeds   one   a,<^ainst    the   otherd       Miss 
.\i,L;hti^,l,^■^le   ^\ith   her  whole    family   l)elon,i;[ed   to 
ihat  setX'Her  circle  which  rose  al)n\-e  narrow  sec- 
tarian, preiudiee.      Her  heart  went  out  e(}ually  to 
Mrs.    Fry   die    Cjuaker,   Pastor   Flk'dner  the   Lu- 
theran,   and    the  Catholic   Sisters  of   .Mercv.    but 
the  bu/zin;.;  i  if  intolerance  must  sometimes  have 
risi'ii  to  her  ears.     Lady  Byron  once  wrote:     "I 
hope    you    ha\-e    traced    the    course    of    Florence 
Xightin,uale.     She  has  i)laced.  women  in  the  vvj^ht 
position,  as  head  of  the  hnuuiuc  department.  .  .  . 
The   enmity   towards   her  appears   from    various 
testimonials  to  be  increased,  but  she  smiles  at  il 
alb-an  an,i,rl  smile."     Dean  Stanley  in  a  letter 
said:  "In  this  nurse  busint-ss  there  is  no  rjue^tion 
that   the  nabid    Prot(>stant   jiarty  ha\"e  sh.own  bv 
far  the  .>-;re;itest  inca]);icity  for  tnhTatini^f  anrthinu' 
be\-iind  their  own  infinitely  little  minds";  and  he 
then  related   how  his  sister  was  stopped  one  da\' 
in  the  husintal  b;/  (he  chaplain,  who  complained 
I'f  ha\-inLC  found  a  c(i])y  of  Keble's  Christian   War 
in  the  wards.      The  next  Sunday,  in  the  ]iresenei' 
of    Miss    Stanley    and    her    nurses,    this   chaplain 
]ireache(l   aL,^;iinst   lu'fself  :ind   them   as   "creeping,' 
in  unawares."  -      Mr.  ( )sb(irne  wrote  of  .Miss  Xight 
int^ale:   "I  have  heard  and  read  with  indij^natioii 

I  The   Tinu-s.   Oct.   24.    ICS54. 

*  Lijc  and  Letters  oj  Dean  Staiihv.  vot  i  ,  j).  41)2. 


Mi>s  Xightin-alc  and  Crimean  War  16;, 


rrinarks  huzanldl  iq 


I  I'nuiiil  her  nn-sclf  to  he  in  cwtn- 


><m  hvv  rvh'/vms  chaniclrr. 


\\l    11"! 


a    Chrisliaii;    1    i 
would   ha\-c   hfcn 


anil  art  i<  iti 


hou,L[ln    this    (juile   c'liou.L^h.      It 

ii"'   ni_\-   opinion    ihe  most   cruel 

^^■on]s  and  a.ets  to 

liodics    of    true 


impertinence  to  scrutinise  her 
discover  to  which  of  the  many 
Christians  she  belon.c^red."  The' Sisters  of  Mercy 
have  recorde.l  the  warnin.L,'  letters  they  received 
from  the  War  (Jftice.  insjured.  as  thev  felt,  by  some 
of  the  Protestant  clergy,  and  remindui;^'  them  that 
they  were  only  nurses,  and  that  vSt.  Paul  had  said 
women  were  not  to  teach  or  preach.     But  "mil- 


'ns  of  tract 


(list 


s      most  ofl'ensive  to  Cat  hoi 


les  were 
and   the 


(hstriljuted  amon.i;  the  Catholic  soldiers, 

Sisters  t'ound    them   in   every  supply  of  cIothin,L,' 

.sent  out  of  lin.Ljland.' 

Sister  Mary  Aloysius,  who  j)ossessed  a  threat 
fund  of  humour,  described  \i\-aciously  the  merri- 
ment caused  in  the  nursin.ij:  stal'f  by  ponderouslv 
•solenm  warnin.i^^s  a.<j:ainst  popery  in  the  Ent^lish 
papers. 

As  a  result  of  one  tirade,  the  Sisters  named  Miss 
.\'i,-htin,<,Mle  "Your  Holiness"  and  she  in  turn 
(  died  one  of  them  ahv.ays  "the  Cardinal."  - 

Besides  reIi,uious  susj)icion  it  seems  probable 
that  the  racial  t'umity  of  Ci'lt  for  Ivn-lish  insj)ired 
some  unfriendly  acts;  such  was  perhaps  the  source 
"f   certain  medical  anta<.,'onisms  and  of  the  pett\- 

.4  Sister  c'  Mercy's  Mrmori.-s  oj  „';,•  Crini.-a.  .Sifter  Mary 
Al-pysiuiS,  Burns  &  Oatcs,      jtidon,  1904,  p.  41. 
•/6tJ.,p.  89. 


64 


A  History  of  NursiivT 


refusal  nf  hospital  nfficials  at  Balaclava  to  allow 
Miss  Xii^'htirii^alc  to  put  up  a  tent  which  she  hail 
niaijc  to  s'.icltcr  tlu'  con\-alcsccnts  from  the  j^lar- 
ing  sun;  aui!  the  sanie  moti\e  is  irresistibly  sug- 
gested by  the  otherwise  inexplicable  animosity  of 
a  volume  pulilished  in  recent  years.' 

Tnaible  with  some  too  zealous  Sisters  ,s  also 
hinted  at  in  Sidney  Heriiert's  letters.-  It  was  a 
periotl  when  religious  enthusiasts  of  a.U  liehefs 
were  keen  to  proselytise.  Whether  the  Sisters 
actually  broke  rules  in  this  res])ect  or  not.  their 
own  chronicles  show  that  the  interest  was  close 
to  their  hearts,  and  in  th.e  miilst  of  hardships 
and  toil  they  found  time  to  prophesv  that  Ladv 
Herbert  and  Miss  StanU'y  would  bec(jme  Catholies, 
as  they  did.' 

How  far  military  and  medical  jealousy  went  no 
one  but  Miss  Nightingale  herself  can  tell.  King- 
lake  says  that  the  military  commander  Sir  George 
Bnnvn  and  his  successor,  Lord  William  Paulet 
were  warm  in  her  jiraise  and  cordially  assented 
when  ihc  War  Minister  wrote:  "You  will  find 
her  most  valuable —her  counsels  are  admirable 
suggestions."  Lord  Raglan,  the  Commander-in- 
chief,  spoke  of  her  as  an  auxiliai-y  gcnt'ral, 
and  ga\-e  her,  according  to  Kinglake,  fniik 
and    cordial    support.      With    hun    she   kept   up 


'  L-avrs  jrom  the  Antials  of  a  '^istrr  of  Mfrc\\      Rv  a  Mem- 
ber of  the  OniiT.     .\e\v  Y(irk,  Catholic  Pub.  S.mcty,  1SS5. 
2  Mi'moirs,  vol.  i.,  pp.  412,417. 
'  Li-avcs  'rem  the  Amuh.  etc.      V..I    ii.,  j.p.   157,  161,  163. 


Miss  Nightingale  and  Crimean  War  165 


a  constant  intcrchanj^x^  of  official  communica- 
tions an.l  he  visited  her  in  her  tenl  when  she  had 
fever.  It  was  naturally  the  bureaucratic  vuider- 
linys,  and  those  who  resented  her  authorit\-,  who 
disliked  her  most— the  re,l-tapc  men,  whose  dense 
mediocrity  was  tf)o  rudely  shocked  by  her  electric 
intellii^^ence.  The  hard-workin.i^^  ward  sui.L^eons, 
and  all  of  those  who  were  tr>-in,L(  to  do  their  dutv, 
re.^arded  her  as  a  powerful  su})[)ort.  Kin,^'lake 
says  that  the  f)verworkcd  and  harassed  surgeons 
used  her  name  as  a  menace  when  the  red-tape 
men  were  too  intolerable,  and  were  wont  to 
threaten  them  el'iectively  with  the  anger  of  the 
Lad\--in-Chief. 

Pincoffs,  who  has  left  one  of  the  best  accounts 
nl  her,  and  who,  as  a  civilian  i)hysician,  had  small 
love  for  his  military  bnAhers,  tells  how  the  junior 
medical  officers  and  orderlies  of  one  division  had 
been  instructed  that  "the  less  they  had  to  do 
with  -Miss  .\i,L,ditin,<,^a]e  and  her  peo])Ie  the  better 
it  would  be  for  them."'  (Me  also  records  that 
a  splendid  dissectinij;  room  was  built,  liberally 
provided  with  numerous  and  excellent  instru- 
ments, microscopes,  chemical  aj^paratus,  etc.  by 
the  1,'overnment.  at  her  su<:,'s^estion. )  ^ 

It  was  the  red-tape  officials  who  complained 
that  she  used  to  hasten  to  get  her  stores  out  first 
"for  fear"  that  the  supplies  would  come  through 
the  regular  channels;  Uiat  she  did  not  give  them 

■  op.  cit..  p.  So. 
'  Ibid.,  p.  55. 


i66  A  Ilistoiv  of  XursiiiLr 


time"    ("it   wis  alwavs    more    time    the 


males 


Nvaii'ed 


savs 


IMIIL 


iIKl 


these   WtTe    t; 


le 


men  whose  feeliiv's 


w 


manded  the 


ere  outraged  \\hen  she  c 


om- 


•rl 


e  orderlies.  (  ui  a 


n  historic  oec; 


ISIOII.    Id 


Ijreak  i'l  the  dnor  of  the  storerooms  and  (hstribute 
supplies  for  whieh  tiie  patients  wvw  sufferini,'. 
(Xolan  says  that  the  authorities  used  to  lock  up 
hrr  i)ri\ate  stores  to  make  it  seem  as  if  they  were 
ni't  needed.)  •  Xaturall_\-,  too.  tlif  ineom])eteiit 
purveyor,  WretV'rd,  who  ^^as  r.naMe  to  hu>'  any- 
tliin;.,'  in  Stamhoul  where  there  were  amijle  mar- 
kets,  must   ha\e  dishked   hw  thorouL:hly.- 

It  is  intimateil  in  vSidne}'  Herbert's  k-tters  that 
slu'  must  ha\-e  had  serious  dilliculties  with  two  of 
the  n;e(!ieal  offieers.  One  of  these  was  Dr.  Hall, 
and  it  is  ol)\ious  on  readini;-  ihvXotcs  on  the  British 
Ar})iy  tliat  the  diiTieult)-  here  arose  from  the 
ineomiKitiliility  of  inrptitud.c  and  ,i;enius.  Tlie 
calibre  of  Dr.  Hall  is  shown  in  the  ol'ticial  cor- 
respondence summed  up  ])y  Miss  XiL,^htingale  in 
her  .Vo/c.s- :  on  March  \2  he  wrote  to  the  London 
olhce  a  scries  ^A  optimistic  inaccuracies  about  the 
health  of  the  army,  and  said: 

Asystcmof  (lotraclion  has  been  rommencod  a.Lrainst 
our  establishments  and  has  been  kt-pt  \\y  hv  nUeresud 
jiarties,  under  the  .trarb  of  philanthropy. 


'  The  llliistraU.1  History  of  the  War  icith  A'h.vsm,  E.  H.  Xcilan 
Ph.U.,   I.L  I)  ,  j.  S.  Virtue,   London,   i.S?-,  p.  710. 

2  On  this,  hypercriticism  could  scarcely  go  further  th:in 
Lord  Stanniorc's  j.eevish  qucr\-  as  to  whether  she  told  this 
inirveyor  where  he  could  buy.     Memoirs,  vol.  i.,  p.  38 1. 


Miss  Nightingale  and  Crimean  War  167 


Sninc-  of  these  detractors,  lie  adds,  have  become  so, 
mi'    reputation,    and    others    /, 


■/('    revain    lost    uv 


vta 


<ke  til 


'cir  mission 


Of     iui; 


't'riaiiie    an 


d  tlh 


eis 


the  'avrld  to   believe   that   all   tli 


h 


'(■   ameliorations   in 


our  institutions  a 


re   e>itirelv  o:eini.'  either   to   tli, 


cien  cxcrti(in: 


s  or 


tlu 


'.ST    () 


'/    "    /' 


e:e  nurses;  ani 


ir 


ai 


sorrv  to  sav  som 


le  of  ovir  own  drpartni- nt   hi[\o 
pandcre<i  to  this  an<l  have  l)een  rewanled  fo,-  it."  ' 
Anntlier      interesting,^     exani;)Ie      of     ini^'eniims 
evasion  was  the  ti'stiniony  t^nveii  hv  Dr.   Ah'-izies 
before  the  House  of  Commons  commiitee  as  to  a 
r.iw  mutton  chop  ha\in,i,'  been  t,'i\cn  to  ;i  patient 
The  e.-planation  .i,n\-en   ]>y    the    {jurwvor    (a,^ain 
.Mr.  Wreford;  was  that  Ab'ss  Xi,i,'htin,L;ale  and  her 
nurses  took  tip  so  niueli  rof^m  and   time   in  the 
general  kitchen  tliat  the  cooks  could  not  do  their 
work.     The  testimony  of  the  cook  himseh"  after- 
wards   proved    that   "  ^bss    Xi^t^ditin^ale    and    her 
nurses  never  set  foot  in  the  j^encra]  kitchen."- 
Still    another    misrepresentation,     which     .Miss 
Xi^htinj^ale  records,  is  contained  in  remarks  in  a 
letter  from  Lord  Paulet  to  Lord  Panmure  in  April, 
i855,inwhichheret\Tsto  MissXi,i(htin,^:aie"s"e.\ten- 
sivcestablishment  "asmakin.o^nrreat  e.xtra  work, and 
also  remarks  that    he    has"  continual  applications 
from  the  ladies  and  nurses  for  extra  expenses."  i 

She  follows  this  with  exact    fi.i^nires  about   her 
sources    of    i)ri\ate    funds    and    their    use    which 

'  Xotes  on  the  British  Anuy.  prulace  to  sec.    i,   i>p.    x.xiv.- 
XXV.     The  italics  are  ours. 

'  Ibui.,   p.   363. 

>  Ibid.,  preface  to  sec.  iii,  p.  .xii. 


1 68 


A  History  of  Xursini: 


prf)ve    the   second    statement    t 
tirelv  false,  and  of  t 


lie  lormer,  remarks 


o    ha\-e 


)een    m- 


Miss  Xightinj^alc 


s  "extensive  establishment. 


sistinj^  of  40  women,  was  housed  in  tlie  B 


c'ln- 


lital    in    til 


e    same    Sfiace    whic 


quarters,  was  oceu 


pied 


arrac 
orrcs] 


k  h< 


)ond 


in« 


\>y  tbri-e  medical 


'111 


.  rs  and 


their  servants,  and  in  about  the  same  spae 
OK  upieil    by   the   ComniancKant.     T 


e  as  was 


irder  t^ 


overerowded  hospital.      It  <mu1 


m.ake  nil  pressure   1' >r  n 


iin 


lis    was   d<inc    in 
'11   an  alrcadv 


ni. 


h 


:i\'e 


with   justice   to   the   wnmei 
XiKditin<,'alc  later  taken  a  1 


lu'cn 


il'  inc 


's    health,    had    wm    M 


louse  in  Scutari  at 


e.xjiense,   to   which   exerv 


ISS 

private 


nurse  attacked   with   fever 


was  remo\  cL' 

But,  anno/injj  as  these  incidents  may  liave  been 
at  tlie  time,  th(>y  wvro  swopt  auMV  in  tju'  Hood  of 
the  de\-oii(in  of  the  ;irm_\-,  and  public  -ratitude 
aiv!  recoi,'n!tion,  whicli  r<  i>o  to  ;i  hoi^^ht  rarcl\- 
kiinwn.  and  remained  dei'p  and  .steadfast  with  a 
l-'\-alty  seldom  e.pi.,lle.l.  After  the  lab-nirs  "i 
the  Crimean  War  were  o\-er  there  were  some  \vh- 
felt  aj,'j,'neved,  (ir  [lerhaps  it  would  he  better  to 
say  woiuided,  that  where  so  many  had  etjualiy 
stri\-cn  and  iM.rne  hardship  ;,nd  unspeakable 
(lifliculties,  e(|uallv  bra\  m.L.:  .leath  .and  e'|uallv 
riskin-,'  partinj,'  from  hotne  and  friends,  the  whole 
passion  of  recognition,  j^'ratitude,  .and  praise  of 
the  En.Lrlish  nation  should  be  poured  at  the  feet 
of   one    nurse -Miss    Ni^'htinj,'ale. 

Dr.  South  in  a  printed  pamphlet  rojjrcttcd  the 
'  Xolis  on  the  British  Army,  i)ref..  stv.  iii,  xx.xii,,  xxxiii 


Aii-ss  Nightingale  and  Crimean  War  169 

nbsrncr  of  any  puMic  recognition  of  the  serxiccs 
lit  Mrs.  Robc'ils,  wlioni  hv  considered  to  have  been 
more  exi)erienced  and  skilled  in  surgical  nursinjj; 
than  any  one  in  the  Crimea.      Xo  doul)t  the  friends 


snppiirters    of    the    other    x'l'lnnteer 


:eni 


WMnien  on  ihr  nnrsin.ij  staff  ma\-  also  haw  ft'lt 
that  they  too  should  have  bcm  nmre  puMielx- 
recognised;  especialh-  those  wIim  liad  luld  super- 
\-isory  positions,  as  Miss  EmUy  llmtun,  who  was 


the  ladv 


■.uprrintendrnl  of  the 


K 


'  uilalee  hosintal 


<  r 


Miss  W 


eau'.   who   h..id   eharee  ', 


^till 


another, 


or  Miss  Stanley,  \vhosho\ve(]  jii^h  de\-otion  and  an 
exquisite  spirit.'  And  the  frimds  of  the  Sisters 
of  Mercy,  whose  endurance  an  'infailin.i,^  cheer- 
fulness under  han'ship  had  excittd  tlu-  admira- 
tion of  all  who  saw  thcin.  iria\-  ha\e  felt  \hc  same 
thing,  for  Cardinal  Wiseman,  in  a  puMie  scrnK'i), 
liad  saifl :  2  "It  must  hax'c  lieen  a  source  of  pain 
to  Roman  Catholics  that  no  manifestation  nf 
teeliiiL:  had  e\ a  r  ln-cn  witnessed  toward  theiii  [ihe 
Sisters]   wliile   chantv    th..t    had    spruui;   up   sud- 

'  "i!\-  in  the  wi.rM  had   txi'ii   hon.uu-ed   liv  rov.al 

I'laiseanfl  eonnnemorated  by  lasting  monuments." 

But  the  actual  significance  of  the  unexampled 

hom;'ge    offered    to    Miss    Nightingale    was    not 

•asped  by  any  one  of  these  critics, — not  li\-  1  )r. 
>  uth,   and    not    by  Canaii.il     Wiseman.      From 


'  Si'p  her  article  Ten  Days  in  tht  Crim-a  A  A".  ih-'hA, >>..•,  c 
'  i^miUan's  Matiazine,  Feb.,  iSOj. 

•  Ouotfd  in  letter  of  Kttiily  Mutton,  m  .\Umoru:>  oj  the 
'imca,  by  Sister  Mary  Aloysius.  ji.  77. 


"o  A  History  of  Xiirsin;^- 


lluir  staiKipdint    lhr\-  wvw  ri.u'Iit  ;  hut   tlic  truth, 
\-;i,L;uc'ly  .-ijipnlK'Hik' :  if  not  (Icfini'il  l)v  thr   Ktv^ 


iish  pc''i](|L'  and  l>\-  thousands  o 


f  ol 


iscTNcrs  111  dtlu  r 


lands,  was  that  with   AH.ns   Xi.^^ditin.i 
on  the  scene  there  h 


iile  s  entrance 


Ml  risen  a  new  ule.al 


itV 


a  new- 


estimate   (it"   nursinu 


and 


its   j)f)ssil)ilities.     Gone 


ftjrever,  froni  the  time  when  she  apj)hed  her 


Icct  to  the 


prolilenis  I  )f 


intel- 

the  Crimea,  was  the  con- 


ceptinn    of    nursin.i,^    as    a     charit\-.     e.\eeedin.^]\- 
nierilorious  ;ind  di'Ser\in'4  of  the  hcavenlv  r 


I's   seU 


•sacrifiein'j;  charactei 


self- 


"eward 
sacri- 


liee  ri'inained,  but  und.er  her  swav  nursin.i,'  shone 
forth  as  a  part  of  the  inxdncilile  and  ,L;lorious  ad,- 
v.inee  ot  scit'iice;  sanitary  science,  the  scicmce  o| 
health,  first, 
\(  .t 


ine 


i)it  \- 


alone 


but 


(hse.ise    onlv    second.inlw 
]'re\ention    foremost;   not 
only  t!ie  amelioration  Init  the  reduction  of  sutTer- 
Avas   now  typified  in   the  personalitv  of  this 


mi 


woman  not  only  as  .a  possihilitv, 
j)oliey  f'or  future  iL^eneralions.  A- 
little  lamp  (lissij)ated.  the  .ltIooiu  of  the  loni,'  corri- 


l)ut   a   positi\-c 
her  f'ar-fanied 


dors  at  vScutari,  so  1 


f     St 


ler  <,;enuis  bai 


lishe 


(1  old  mists 


uprlity,     inisconception,     and     loni^-settli'd 
customs  in  the  realms  of  thoui,'ht. 

Sickness,  throu.i;li  so  many  centuries  rcKanled 
as  divine  ven^^eance  for  "orij.^Mnal  sin"— fear- 
inspirini'  and  mvsterious  -wliat  does  she  say  of 
it.^ 

Sickness  or  disease  is  Xalure's  way  of  pcttinp  rid 
of  the  effects  (if  conditions  which  have  interfered 
with  liealtli.     It  is  Nature's  aliemj)t  to  cure. 


Miss  Xio-htino-alc  and  Crimean  War  171 


And  n{  nursin,l,^  Inw^  rcs^anlcd  li\-  tl 
the  hank'st  "f  sacrific 


ic  devout  as 


■cs,  and   Ii\-  \hv  laitv 


as  an 


'ccupalion  inexpressibly  1 


I'W  and  ivput^nant 


Xur 


SIIlL 


wn 


is  ])uttin,<j:  us  in  the  best  possible  eondii 
It  lire  to  restore  or  to   preserve  health,  to  j 


t  or  lo  euro  disejise  or  injurv 


to  enal 


Ion 
)re- 
Xa- 


tiire  to  set  U])  her  restorative  proeesses;  to  expel  the 
intruder  disturl)in,s^  iier  rules  of  health  and  life, 
r.a-tly.   perhaps  niaiidv.  u' 


uiu 


■ther  Xature  sueeecdsor  fails  in  1 


i"!i   iuu-siiiL,r  must   de 


:jeii(| 


>v  siekness 


Xursi 


lierattenijit  toiun 


n^'  is  therefore  to  help  the  |)atiLnt 


to  live.  XursinsT  is  an  art,  and  an  art  recj 


iM'il  i)ra(tual 


aui 


scientifie  trainii 


uinnijan  or^an- 


the  skilled  servant  of  nied 


!• 


ienie,sur;,a-rv,  and  h 


ir  nursin^f 
■giene 


is 


And  v/hat  says  she  of  the  nurse's  attitude 
l"\\ar(i  life?  For  many  centuries  it  had  been  a 
favorite  d().t,rma  r)r  churchmen  th.it  an  inclination 
tosuch  work  defied  thenorm.d  human  interest  aii<I 
sym{)athies  and  could  Muly  bo  based  on  some  tran.s- 
cendental  or  supcrn, aural  iiMtive.      lUit  he.ir  her: 

I  ^dve  a  quarter  (.f  a  century's  European  exprrience 
when  I  say  that  the  hapjncst  people,  the  f.,ndest  nf 
their  occupation,  the  most  thankful  fur  their  lives,  are. 
in  my  opinion,  those  enj,'a<(ed  in  siek-nursing.  It  is 
a  mere  abuse  of  words  to  rci)resent  the  life,  as  is  done 
hy  S(jmc,  as  a  sacrifice  and  a  martyrdom.  Hut  there 
have  been  mart>TS  in  it.  The  founders  and  i)iuneers 
'■!  almost  everythinjr  that  is  best  must  be  martvrs. 
Ihu  these  are  the  last  ever  to  think  themselves  s.'..-' 

Artiilc  on  .V«r.s(iar  //„•  Suk  from  (Juaiirs  Dictionary  oj 

li.Dic.  Edition  of  i8(>4. 

Introd.  to  Liji-  oj  Agues  Jows.  pp.  x.\x  x.x.xi. 


CHAPTER  IV 
Till':  \iGirri.\GALi-:  school  i'or  nurses  at  st. 

TIKJ.MAS'S  IIOSI'ITAL 


Till",  desire  of  llie  liritish  ])e(i])k'  to  otTer  Miss 
XiLf'iViiu^alc  ;l  toslini; )iiKtl  h.id  been  ex- 
pressei'i  ;il  ;i  i>ulilii"  nuetini^^  held  at  Willis's 
Kooiiis,  (III  Xovcniber  29,  iS;5.  She  must  long 
haw  eherished  the  wish  to  t'oini<l  a  training;  school 
lor  nurses;  for  her  friends  the  Sidney  Herberts. 
wIk'II  eonsulted  as  to  th(.'  form  the  testimonial 
niiyht  taki',  wen'  alile  from  their  intimate  know- 
ledge of  her  to  ad\ise  that  the  one  thing  she  would 
be  willing  t<j  accept  would  be  the  means  of  found- 
ing such  a  school.  The  Duke  of  Cambridge  presided 
at  the  meeting  ,ind  the  distinguished  company 
j)resent  representc<l  the  ])rogressi\e  and  fi'e(  r 
minds  rather  than  those  of  anv  strict  or  rigid 
tenets.  The  bishops  of  the  Church  were  mostly  ab- 
sent; but  Dean  Stanley  was  there;  (ilailstone  sent 
a  letter  of  apology;  Sir  jaiiies  Clark.  .Ml).,  Mr. 
C.  I.oe.irk,  M.I)..  Mr.  II.  \]vuvc  joni's.  M.D..  and 
.Mr  W.  HMWtnan  ■  .f  the  Roy;,l  ("ollege  of  Surgeons 
Were  mentioned  in  the  list  of  those  present.  The 
Duke  of  Cambridge,  after  stating  the  object  of  ilif 

1:2 


The  \i<^ditingalc  School  for  Xiirsc.>    i;;, 

lncctin^^  sug^^cslcd  that  the  olYenni,^  of  tlu-  people 
he  raised  with  a  \ie\v  oi  esta1ilishin,i;  a  system  oi 
nurses  under  Miss  Xi,i4htin,L;ale's  immediate  cnn- 
tml,  and  that  she  should  be  ]v\i  unfettenvl  to 
select  her  own  enuneil.  The  Marquis  oi  Laus- 
<li)\vnc  in  seennding  ^aid; 

One  (if  tlie  most  useful  lessons  of  the  war  would  be 
the  permanent  imprcvement  in  the  duty  of  attending 
t!ie  siek  and  wounded  soldiers,  as  the  part  taken  by 
the  ladies  of  the  eountry  m  organisinj^  and  inspirinj^ 
that  iniprownient  would  be  amon.<;  its  most  j^dorious 
fininiseenees.  .  .  .  [Ho  moved]  that  the  nolile 
I'xertions  of  .Miss  Xi,i,duin,<,'alc  and  her  assoeiates  in 
the  hosphals  of  tlie  Kast  and  thie  valuable  services 
rendered  by  them  t(.  the  sick  and  wounded  of  the 
Hritish  forces  demand  the  grateful  recogtulion  of  the 
British  people. 


Sir  James  Pakin,i!;ton  j)roj)nsed  a  resnlutidn  that 
funds  tie  raised  to  "enable  her  to  establish  an 
mstitution  Inr  the  training,  sustenance,  and  pro- 
tection <if  nurses  and  hosoital  attendants." 

Sir  James  Clark,  lor  the  medical  profession,  said 
that  he  had  had  the  pleasure  of  being  aeijuainlod 
v.ith  Miss  Nightingale  for  main-  w^ars.  L"ng 
heforc  the-  war  was  thought  <A  he  had  kn-iwn  ln^r 
to  watch  day  and  night  by  tlie  bedsides  <>(  the 
siek,  and  knowing  the  In'auty  and  goodness  of  her 

irat  ter  it  w.is  with  no  common  feelings  of  ad- 
miration ho  had  \\:it(  hod  her  career  in  the  Ive  ! . 
He  did   not   doubt    the   noble   exertions  of   Mi   , 


174 


A  Hi^torv  of  \ur 


Xi.i^htinsjjalc  wi'uld  ])ni\c  ;i  pcrniaiic 
the  v.li<ilf  cMunlrv. 


iiL  hi 


L'SSlIl'^  {i 


Mr.  Siihif\'  1  Icrlic'rl  spoke  canicstly  aiiil  to  the 
k'a\'in'./   lirr  \'rvv   lo  diivcl    hvr 


le   II  r; 


111  luT  \\"o  liax'c  a  wotnan  ot  jrcnius. 


point, 
srhool,  I'd!" 

i  k'  toM  of  ha\"in,L,'  \'isitc'(l  ]\cr  at  Kaiscrswcrth,  ':)i 
\\\\ii\  lie  hail  heard  t'rom  tlie  Idiedncrs  of  her  ii;rcat 
aliiHty;  lie  had  no  hesitati'Ui  in  sa_\-ini,^  that  durini; 
tlu'  course  of  the  war  Miss  Xi,L,ditin,L,Mle  had  twhih- 
ited  greater  ])o\vers  of  (Organisation,  a  ,yreater  fa- 
miliarity witli  details,  with  a  eonipre 


hens 


ive  view 


.1    til 


general 


beai-inirs  of   the  subieet,  than   h; 


n 
tlu 


larkei]    the   e-'ivluet  of  an\-   one  eonneeted   with 


nosT)itals    (inntiL 


the    war. 


told 


s'  inie 


anecdotes  ji[athered  from  the  soldiers 
kissed  her  shadov/  as  it  fell  on  them: 


—how  they 


She  wmiM  spcal^  [<>  mu'  and  aimther,  and  nod  and 
smile  to  as  many  more,  but  she  c-onld  n't  do  it  id  ail, 
\'ou  know,  for  wc  lay  there  1>\'  the  luindreds,  hut  '.ve 
1  kiss  her  shadow  ;is  it    fell  and  la\-  hark  on  our 


Wi  'Ul 


pilliiws  eontcnt. 


And 


now  o 


ne  said]  before  she 


lanic 


there  was  sueh  eus^in'  and  swearin',  but  after  that  il 


was  as 


hoi', 


as  a  c 


liureh. 


And  the  Tiu'ctinij;  ended  with  threat  ent  hiisi.ism.' 
In  januar\,  i  S;M.  while  si  ill  in  the  ("rniie,i,  Mi- 
Xightin[i;ale    h; 


renlie' 


to    a    li/tter   embodxant 


the  proposals  of  the  testinioni.il  commit  \cc: 

Exposed   as   I   am   to  be  misinterpreted  and  mis- 

'  The  Times.  Nov    ^o,  1855. 

A  number  of  otluT  puMic  meetings.  ciu'iUy  successful, 
were  held  in  ditTorent  piirts  of  (Ire/it  Hrit.iin  See  Report 
oj  the  Committee  oj  fhe  Xightiu^alc  Fund.     London,  1856. 


The  Nightingale  School  for  Nurses    175 


understond  in  a  field  of  actif 


in  in  which  the  work  is 


new 
jud 


com 
mient 


plicated,  and  distant  fruni  manv  who  sit 


in 


on  It,   It   IS  in 


(leeii  an  ah 


idin 


g  suppcirt    to 


rou 


have  such  sympatliy  and  such  appreciation  1 
home  to  nie  in  tiie  midst   of  labours  and  difficult 
aP    but   overi)owcriu(,r.      I    nuist    add.    hn^Vl■^•'-r     tl 


les 


ev'T,    that 


my  present  work  is  such  as  I  would  newr  desert  fur 
any  other,  as  lon.i,'  as  I  see  room  to  belic\-e  that  what 


nay  dn  here  is  unlmisheil.      .Mav  I,  then,  1 


lej^  you  in 


express  t(J  the  committee  that  I  acecjit  their  proposal, 
provided  I  may  do  so  on  their  understanding  of  this 
,i,Teat  uncertainty  as  to  when  it  will  be  i)ossible  fc^r 
nie  to  eari_\-  it  out.^ 

A  ])leasin<i[  detail,  whicli  nurses  as  a  rtilc  do  rmt 
know,  was  that  the  soldiers  tlu'iiiseh-es  roT-itril)Uted 
over  £4000  to  the  Xi,u;hti!yi,'a!e  ftind.  The 
military  s-cretary,  n-ritin;.;  from  headquarters  in 
iS;r>.  said: 

.  .  .  The  subscription  lias  been  the  result  of  vri]- 
untary  individual  .  iticrin.L^s,  and  plainl\-  indicates 
t'r.e  uni\-tTsa!  feeling  nf  gratitude  winch  exists  among 
the  troops  engaged  in  the  Crimea  fur  th(>  care  bestowed 
upon,  the  ndicf  administered  ti..  themselves  and  their 
comrades,  at  the  period  of  their  greatest  sutTerings, 
!'V  the  skiltui  arrangements,  the  unwearving,  con- 
stant, personal  attenliun  d  Miss  Xighiingale  and  the 
"tiler  ladies  associated   witli   lu  r.   .   .   .-' 

When,  after  Miss  Xiglitingale's  return  from  the 

Crime.a,  it  was.  after  ,1  f^-w  vears  of  waiting,  ni.-ide 

''  '11   Ihat   her  hcdth  wotiKl  iKjf  jJernHt  her  to 

Wititle,  of.  tit.,  p.   121. 
■  Ibid,  p,  122. 


176 


A  History  of  Nursing 


direct  in  person  the  pn.mised  school  for  nurses 
the  responsibihty  was  phiced  in  the  hands  of  a 
committer,  .  nd  St.  Thomas's  hospital  selected  as 
V.K  J /lace  to  try  the  experiment.  Dr.  Blackwell 
refers  to  this  period  of  her  life  in  a  letter  written 
ti  I  her  sister  in  1851;. 

Have  just  returned  from  an  interview  with  Miss 
Xightingalc  m  relation  to  a  seliDol  for  nurses  whirh  she 
wishes  to  establish.  .My  old  friend's  health  is  failing 
frnni  the  pressure  of  mental  labour.  I  ean't  go  into 
the  details  of  her  hist  five  years  now,  but  the  laljour 
has  been  and  is  immense.  I  think  I  have  never  known 
a  woman  labour  as  she  has  done.  It  is  a  most  re- 
markable experienee.  She  indeed  deserves  the  name 
of  a  worker.  Of  course  we  conversed  verv  earnestlv 
about  the  numerous  plans  in  which  she  wished  to 
interest  me.  She  thinks  her  own  health  will  never 
permit  her  to  carry  out  her  plan  herself  and  I  much 
fear  she  is  right  in  this  belief.' 

The   new   school    was   not   established    without 
much  hostile  comment  .and   criticism.      Flippant 
society  ladies,  like  Lady  Pam,  thought  the  Nightin- 
gale fund 
great   hund)ug.    .   .   .   The  nurses  are  very  goiMl  now, 

'  I'ioncr  Work  in  i  )pcuiiii^  the  Mrdical  Proirssion  to  Wo- 
nil}},  L.  iiii^'ni.ms.  (ireen  \-  Cn.,  pp.  217,  21S.  .\s.  after  her 
return  frwm  Ihc  Criine.i,  .Mi>s  .\i;.,'liting.i1e  had  fouyht  al- 
most sini^le-hamieii.  e.xtei>t  for  Suiney  Hert)erfs  help,  the 
liattle  to  Dvertvini  the  aini(]uateii  hut  stron^^'lv  intrcncheii 
iiiaehiiiery  whieh  had  nearly  destnixed  the  British  army, 
those  who  knii'.v  tile  eost  at  which  sui  h  work  is  done  may 
readily  eoujeeture  th;it  Dr.  Blaekwell's  remark  may  have 
referred  to  this  as  the  drain  on  Miss  Xightingalj's  health. 


The  Nightingale  School  for  Xurscs    i;; 


ihimgli  perhaps  ihcy  do  drink  a  little,  but  so  do  the 
ladies'   monthlv   nurses,   and    noijiiiu 


m  th 


tm 


]"  «>r  jjeuple,  it  uuist  he  so  t 


ean    he    better 
ireSMine  sit  tins.,' 


up  all  night,  and  it   they  do  drink  a  little  too  itiueli 
the)'  are  turmd  a\va\'  auii  others  got! 


Sir; 


inge  as   ii   m  i_\-   socni,   the   rr.aioiitv   <>!    the 


medical  men  ol"  the  day  a])pear  b>  haw  been,  ii' 
not  (listinetl_\-  unfriendly,  at  least  far  from  conHa! 
supporters  of  the   propose.!    ])]an,  and   those  who 


liaii 


been  direi'tl\-  eoncerne(l  with  the 


manawment 


o?'  the  nnrses  under  the  old  sx'ste 


ni  regarded 


the 


one  as  a  so 


rt  of 


an  at'front.      vStich,  ;d   le.ast, 


who    wrote   a 


was    the    assertion    of    Dr.    Sotith, 

jainphlet    ailverse    to    tlie    projected    XighlingaK 


noi  (I 
h'  >mas's 


Dr.    Snuth    was    senior 


surgei  m    a 


t    St. 


ospit; 


U, 


was 


TohabK'    i 


the  old   school,   liked    to   hax'e   1 


pnto 


lis  nurses  o 


plane  of 


domestic  serx'ants,  was  j)atronisin 


n  thi 

g  and 


kimllv 


disposrd  to  those  who  ser\-e<l  him,  and  not 


too  exact iiu 


m   his  own   ixciuirement^ 


He 


ic  was 

very  loyal  to  .Mrs.  Roberts,  wb,o  had  been  Sister 
in  his  wards  fnr  owr  tveiity  years,  and  felt  some 
chagrin  that  she  had  not  received  more  popular 
applause  fe)r  her  share  of  the  toils  and  reforms  of 
the  Crimea.  His  arguments  are  worth  rexiewing, 
hecaiLse  they  show  so  plainly  what  a  different  idea 
was  i)rcscnt  at  that  time  m  the  tiverage  medical 
mind  of  what  nursing  n'.dly  miglit  mean,  and 
how  little  he  actual]}-  undlerstood  of  what  Miss 
Xightingale  wanted  to  do.  He  dirfen.ied  the 
i  1-fa.shioned    nursing    svstem    as    excellent    and 


i;8 


A  History  of  XursiiiLT 


satisfactory;  warmly  (Icfc^ndc^l   thr  charact 
conduct  (if  tlir  Sifters'  (l)an'I\- 


or  aiiil 


mciiti' lninL,^   hnv- 


cvcr,  the  srr\-ant-!iurscs,  with  wlioni  h 


did  nfn  cnnu-  in  contact):  and  <j[avc  a 
the  work  of  tl 


c  [)rol)at)Iv 


n  account  of 


ic  nurses  and  Sisters  and  th 


tliev  ".vere  trained. 


Til 


e    irainin<^   of    the    SistiTS 


and 


th 


e 


e  wa\- 


Zeneni 


control  of  the  nursins/  work  had  1 


een  entirelv  iii 


the  hands  of  the  medical  staff.  This  is  an  import- 
ant point  to  notice,  and  it  was,  no  doubt,  rea.son 
enou.uh  for  the  resentment   felt   bv  medical  men 


not 


at  the  proposal  chani^'e.  The  Sisters  were 
tauL^dit  by  the  matron,  but  by  the  sur.L^vons  an^l 
physicians.  They  were,  however,  taken  first 
into  the  matron's  office,  and  by  e'-rands  and  by 
substitutin.tj:  in  the  wards  they  ^ijjradually  learned 
the  hospital  ways.  They  were  then  j)ut  on  !)ro- 
iKiiion  in  the  wards  and  were  trained  into  their 
duties  by  the  phy.sicians.  The  terms  "nurse" 
and  "wardmaid"  were  synonymous,  and  either 
nurse  or  Sister  mi^ht  be  called  ujion  to  re- 
m;.in  on  dutv  all  nii.,dit  after  a  dav  of  toutleeii 
hours,  durinjj^  which  tinu-,  the  writer  adds  in 
cidentall}-.  they  "raiely"  .sat  down  for  five  niin- 


'  The  superior  rank  of  the  Sister  li.'id  Ijeen  I'lnphasisedin 
i6q<j,  by  an  ordinance  that  only  the  wives  of  freemen  should 
be  appointed  Sisters.  In  the  year  1752  the  degradation  of 
hospital  work  is  indicated  by  an  attempt  of  the  governors  to 
change  the  name  "  Sister"  to  "  \urse,"  and  that  of  nurse  to 
"  helper,"  but  custom  was  too  strong  a.nd  the  use  of  the 
familiar  terms  continued.  An  Iltstoriral  Account  of  St. 
Thomas's  Hospital      Benj    Gnlding.  Londun,  iSio,  ji,  207. 


The  Xi;^htini^alc  School  lor  Nurses 


TO 


Will 


Uv  then  (.' insiilcrcil  the  imiposeil  nicctiii' 


IS  S    Ri  mills    III] 


ironvitt'  Miss  Xi''htiiu'ak''s 


III   for  teachiii!^'  Tiursi'S,   .mil   (U'(l;in.'il    that    the 


>P  ipOSCf 


schi 


llu 


lOUS 


was  ijuitc  iir.nL'CL'Ssary  ami  supri"- 
that   stati-iiu'iits  made  as  to  the   mirsiiij^^ 


inefficiencv  am 


had 


•  ilten^i 


anu 


conditions  in  hospitals  were 
untrue;     that    vSidnev    Herbert's 


wen 


is,  "It  was  hoped  that  throu.i^h  Miss  Xii^ht 


m- 


)   a 


.f^ale's  proposition  nursin.i,'  would  he  raided  p 
pitch  f>f  effaieney  ne\-er  known  hefori',"  were  i^ot. 
t'l'iinded  on  lact — that  hosjiital  nursiiiL,^  was  not. 
-n!y  effieient  but  was  satisfactory  to  all  the  phy- 
sicians and  surgeons. 


riiat    tills    proposed    lii)Sj)ital-nurso    trai 


nin<: 


sdit-me  lias  not  met  witli  the  approbation  or  suriiMrt 
of  the   medical    profession    is    beyond 


don 


v.Tote 


Am 


on''  til 


('    si'jnt 


TS    of    su! 


bt    [he 
-eriptions   to  the 


XiL^htin.ijjale  l-un*!,  ont  of  ninet\--f.iur  phvsiiian> 
seventy-nine   suri^'eons   from    the   se\-(ntrrn    ho<pital 


III  London,  onlytb.ree  nhysieians  aiii!  one  sur^'eon  fn  im 
line  hospital,  and  on  jilivsirian  from  a  seeond,  are 
fi'imd  a.monir  the  siipjiorters  of  the  seheine. 


tlK 


iiatii'nts    Were    not    asked    what    thev 


::on,uht  of  it.!  This,  to  his  mind,  is  ])roof  that 
:iu'  existing,'  nursin;,;  in  hospitals  was  as  near  as 
p  'ssible  to  beiii.i,'  what  it  should  lie,  and  sutVicient 
use  for  a  natural  resentment  over  attacks  made 
i'V  persons  who  had  no  knowleili^v  of  the  sul)ieet. 
He  proves,  further,  that  there  was  no  need  of  mn-v. 
"  'Tn(>n  for  jiriv.ate  dutv.  since  St.  John's  House 

■:  ':  the  Institute  for  Trainini,^  Xurses  (Mrs.  Fry's) 


i8o 


;\  1  lihloiA  of  Nurhiii' 


wrrc  fillini/  the  whok'  ficli]  and  il'iiii'^  all  that 


ft'(|Uirtv 

ism   on 


if   then  (|niitci!   tlic  I 


)11m\\ 


111', 


n.^iish    liiispitals,   which   is 


tak. 


;    CfltlC- 

n    t'roin 


tile    ])ain])lilrl    <  in 


K; 


i>rrs\\\rth   writtm 


M 


Iss 


\'i.i,^htin,[:aU',   thouL;]!  he  dul   not  appear  to  k 
thr  authi)rshii): 


now 


\Vc  see  [it  ran],  as  every  f)ne  conversant  -with 
hospitals  knows,  a  sclino],  ii  may  almost  he  said,  for 
immorality  and  impro])riety— inevitahle  where  women 
of  bad  character  are  admitted  as  nurses,  to  becfime 
worse  by  their  contact  with  the  male  patients  and 
younsT  surgeons:  inevitable  where  the  nurses  have  t'l 
perform  every  othce  in  the  male  wards,  which  it  is 
undesirable  to  exact  from  wonu'n  of  i^nod  character 
— how  much  more,  imm  those  of  bad '■•-  inevitable 
where  the  examination  of  fcmak'S  must  take  place 
before  a  schf)ol  of  medical  students.  We  see  the 
nurses  drinkin<T,  we  see  the  neglect  at  night  owing  to 
tlnir  faJlini,'  aslee]). 

This  pamphlet  was  jjrinied  withont  Miss  Xi.L;hl- 
in.Ljale's  name,  an!  Dr.  South's  unennseionsness  of 
its  source  is  rather  anuisin;.:  when  he  s.ivs  that 
he  (kn's  not  pretend  to  know  where  "he  or  she" 
j;ot  this  information;  that  it  is  entirelv  nntnie 
as  re.2;:ir(ls  tlie  ntirses  and  a  ijross  libel  on  the 
yotini,^  suryjeons;  addin,^:  tliat  lie  "fears  the 
writer  h.is  fallen  into  \-er\-  had  tnedieal  company"! 
How  (litTerent  was  his  standard  of  niii-sin,<,^  from 
Miss  .\i.L,ditini,^ale"s  can  he  estinicated  by  com- 
jjarini.:  her  hin-'inous  definition  "  Xursinj;  is 
lieli)ing  the  j)atieni  to  Ircc"    wiih    his    amuiblc 


The  Xiyiuingalc  SlIiooI  loi"  Nurses    iSi 


iili'hand     ilcliiiition    of    the    dutii'sof    thr   wan] 
nurses ; 

As  regards  the  nurses  or  wardmaids,  tlusc  arc  in 
much  the  same  posilion  as  houseniaids  and  rt(juiri> 
little  tcai.hin.L;  heyund  llitit  nf  pnuli  i(  r  ^laki^,L,^  which 
is  easily  acquired,  ihe  enlnneniein  i>i  i  K  aiiliiu-NS,  and 
attention  to  the  patients'  wants. 

The  nurses  need  not,  he  lhiid<s,  be  of  the  same 
ehiss  required  for  Sisters,  nor  ha\e  the  sann'  n- 
sponsil'ihtie'S,  nor  do  tlie\'  oftiMi  sta\-  more  than 
one  year  or  two  in  the  wards.  Ihn  \\hat  l)ecame 
o!  them  then,  or  if  they  went  out  to  jinvate  (hit  \-. 
he  does  not  ask.' 

In  spite  of  imhxdihial  dotil.ts  and  ih'>a]);)ro\aK 
a!  witli  the  encoiu-aLji'ment  of  the  more  en- 
li.i^'htene<l  members  of  soeietw-  the  .^dL:lltin,:^^d(■ 
.school  was  opened  with  fifteen  ])rohati<iners  on 
June  15,  i8C>o,  a  date  tor  m.iiu'  reaso.ns,  and  fn  im 
varie(l  standpoints,  the  nvKt  niemoralile  in  the 
history  of  nursin,^:.  I"i  ir  now  was  estahhslied  a 
set    ot    ]>rinci|i!es    dnstinetl_\'   new  or    of    new  a])- 

'  Facts  Riiatiiii^  !o  Hospital  Xiirsr^.  J.  1".  Si)uth.  Lomlun. 

-  Mrs,  Jameson,  who  w.is  somewhat  in  ail\-ancc  of  the 
i'lcas  of  her  own  d.iy,  wrote  tluis:  ■'  It  is  an  undert.akini; 
wholly  I'ew  to  our  En},'lish  eustoms,  miteh  at  \-;inanef  with 
the  usual  ediieaticjn  given  to  women  in  this  eountry.  If  it 
saeceeds,  it  will  be  the  true,  the  lasting  glory  of  ["lurenee 
■Vightingale,  ami  her  liami  of  devoted  assistants,  tii.it  they 
li.ive  t)roken  down  a  'Chinese  wall"  of  prejudices,  religious, 
^•■H-ial,  jirofession.al.  .and  have  established  a  i)reeedent  whieh 
Will  indeed  multiply  the  good  to  all  time."     Wintle,  op.  cit., 


l82 


A  1  listorv  of  Xursinir 


plication  U>  nursin^MinkTs.      Most  sii^mificanl  and 
radical  was  the  iTcoirniti(!ii  nf  science  as  the  su- 
preme authority   in   the  educatinn   , ,(  {h^   nurse 
No  other  CMnilictiu.u'  aalhority  was  hencel'orth  to 
separate  her  path  fmin  thai  of  advancin^f  medical 
knowledge.      With  this,  as  an  inevitable  corollary, 
was  the  complete  secularisation    of    her   calling,'; 
this,  combimd  with  a  resj)eetal)le,  or  it   nii<,dit  he 
even   distinjj^uished,   social   ])ositiiin,   set    her   fne 
for  enlar.;e<l   possihilitx-s  of  usefulness.      \o  less 
far-reaehin},'  was  the  tacit  rejection  of  the  ancient 
corner-stone  of  poverty,  so  loni,'  held  essential  for 
the  nnrse,    whieh   had,  more  than  anything  el;;e, 
kept  h  ;•  hound,  uneilucated,  and  passive.     How- 
ever partially  and  experimentally,  the  new  .system 
started  on  the  direction  following  which  she  was 
enabled   rapidly  to  gain   the  basis  on  which  all 
other  progress  rests,  that  of  econf)mic  independ- 
ence.     Nursing    now   ceased    to   be  a   jh  nance,  a 
self-sacritice,  or   a    merit    ensuring   a    high  i)lact.' 
in  the  next  worid,  and  was  firmly  established  as 
an  honourable,  if  laborious,  means  of  earning  one's 
livelihood. 

The  magnificent  plan  of  the  Nightingale  school 
was  that  it  should  alxivc  all  el.se  i)rcpare  women 
to  go  into  the  hospitals  and  infirmaries  and  there 
carry  on  further  the  work  of  nursing  reformation 
and  teaching,  and  this  plan  has  been  triumphantly 
carried  out.  The  Nightingale  probationers,  as 
they  were  calle<l,  were  not  trained  to  Ikj  priva 
duty  nur.,es.  as  those  of  the  earliest  English  or- 


Tile  Xigluin^ralc  Sclujol  tor  Xui^cs    1S3 


,<,'ani.sati()ns  had  Iktii,  but  wcro  piXTniiiuiitl)- 
■  :  <iura,i,r(l  to  hcconic  ]iii  >iu'('rs.  trachcrs,  aiiil 
rr,L,a'ncralors  in  hospital  niana,i,a'nuiu  and  nursiiv^' 
systems,  and  vSt.  Thomas's  lias  newr  had  a  ])ri\atc 
nursitiii;  department. 

As  vacancies  occurred  in  the  re^^ailar  staff  of  tlie 
hospital  thry  were  filled   l.y   Xij^htin^ale  nurses, 
Si  that,  eventuallw  Mie  old  style  of  ward   nurse 
\\..s  replaced  by  the  new.     It  would  probably  be 
inipossiI)le  to  record  all   the  hosi)itals  that  were 
re.L^eneratcd  by  the  \i,uhtini,'ale  nurses;   the  com- 
mittee preferred,  when  possible,  U)  send  a  j^rouj) 
under  nuc  reeopiised   head  to  initiate  reform  in 
ether  institutions.     This  was  done  in  the  case  of 
tile  Royal    Infirmary  and   the  j^^reat   Workhouse 
Iminnary  at   Liverpool,   the   Royal   Infirmary  at 
IMinburj^'h,    and    a    number    f)f    other    less   well 
known    but   not  less  im])ortant  infinnaries.     Im- 
portant hospitals  in  Ireland,  such  as  Sir  Patrick 
Dun's,   colonial    hospitals,  such  as  the  infirmary 
in    Sydney   and    the    CJencral    hospital    at    .Mon- 
treal, obtained  their  first  trained  heads  from  vSt. 
Thomas's,   as  did   also   Si.    Hartholomcw's;  and 
the   Empress  Victoria  of  Germany,  then  Crown 
Princess  of  Prussia,  sent  Fraulein  Fuhrmann,  wh<, 
•  iiierwards  (leveloj)ed  the  Victoria  House  or  train- 
in.^'  school  for  nurses  in  Berlin,  to  St.  Thomas's  for 
li<  r  preliminary  experience.    The  War  Otlicc  rccf)^- 
ni.^^ed  Miss  Nij,'htinK'ale's  work  by  selecting  a  su- 
i'<  rir.temlent  of  nurses  for  the  Royal  Hospital  at 
-  *I'V  in  i86q,  with  a  stall  of  nurses  to  work  under 


1 84 


A  llislorv  of  Xursiiii. 


her.  Mi-^s  Alico  ImsIkt,  \y]v  regenerated  Blockley 
hosj)ital,  was  a  Xi,i,'htiiiL(ale  nurse,  and  Miss  Linda 
Richards,  the  pioneer  nurse  of  the  United  vStates, 
enjoyed  tlie  ad\-antages  of  post-graduate  work  in 
Si.  Thomas's  and  of  Miss  Nightingale's  personal, 
kindly  interest  and  encouragement. 

Though  later  on  nrwir  schools,  beginning 
more  easily  ^\h^'r^'  tlris  h,i  1  to  break  the  ground, 
first  equalled  it  and  then,  for  a  time,  out-dis- 
tanced it,  none  can  e\er  forget  its  debt  to  this, 
the  mother  se'  ool,  the  first  one  at  once  secular, 
non-sectarian  soundly  organised,  adecjuate  in  its 
hospital  facilities,  and  based  on  teaching.  The 
head  nurses  were  paid  by  the  Nightingale  fund 
for  teaching  the  prob.ationevs,  the  matron  was 
paid  for  supcrinti'nding  them,  and  the  medical 
instructor  for  his  services  in  lectming  to  them. 
Having  been  at  the  outset  a  most  radical  and  dar- 
ing innovation,  the  Nightingale  school  thereafter 
went  steadily  on  its  way,  becoming,  in  time,  con- 
servative through  so  doing,  while  the  forces  it  had 
released  to  action  turned  to  successive  innovations 
and  advanced  to  fresh  revolutions,  with  which  it 
was  not  always  in  symjxithy. 

The  weak  pf)int  (as  it  seems  now  to  us,  though 
it  must  be  noted  that  this  is  not  universally  agreed 
to  jimong  superintendents,  especially  in  England, 
where  a  superior  type  of  woman  is  found  in  d(v 
mestic  service)  in  the  com])osition  of  the  early 
English  schools  was  their  inheritance  and  contin- 
uation  in   modified    form   of   the  servant-nurse, 


"I   111   M.     I  htim.i.-.  •-    II'.! 


i-..^.,  .ilur  llie   tslalilisliiiicnt  ol   llio 


lining'  mIioo!.     O.ie  of  the  oM-limc  mirsi.,  in  tin,.  f.,r,  ..r , 


The  x\i^^rhtinL;•alc  School  for  Nurses    iSs 


lh()up:h  it  MT)uM  1];,\T  I,(vn  lianl  imi  i(,  accx])!  an.l 
cniUiiiuc  to  sonif  extent  a  class  distinction  wiiich 
was  inj/raincd  in  tlic  social  order  and  lia<l  so  Ion,i,f 
characterised    tlie     liospital    ser\a\-c    und.er    ]^>.\h 
lay  and  ivliL^nous  .L;o\ernin^  liodie^.      Kaisers\wrth 
had  i.L^nored  all  class  distinctions,  and  so  had  Mrs. 
Fry'sInstitute,liutcasteha<ircai)iH'ared  in  the  later 
German  ori^anisations,  and  in  tln'  m:i->inL,'  order.- 
nf  the  An,y;lican  Cliurch.      It  would   i)erha])s  liave 
hoen  impossihli'  thm.  at  one  stei),  to  secure  only 
jmjbatii  an'rs  who  were  of  the  dass  of  ,<?entle\vomen 
m  sufficient   nuniliers  to  carry  -m  all  the  work  of 
the  hospitals.      It  seems  to  ha\e  been  tacitly  nn- 
tierstood   in   those  eariv  days  that   private  duty 
nurses,  at  least,  must    he  recruited  lar,y:cly  from 
among  those  of  a  ]i>\\vy  social  ."[fade.     This  was 
not  rc<;arded  with  <listavour,  Imt  rather  the  con- 
trary, and  some  i-:n,-;!ish  matrons  still  h.  ijd  it  ad- 
visable.    .Miss    Xi<,'htin.t,'ale's    writini,^    in    se\eral 
places  indicate  this  i^'cneral  vit'W,  an  !  shr  has  left 
comparisons  between   the  relative  advantages  of 
domestic  ser\  i^e  and   ini'-sing,   showing  that  the 
same  women  might  choose  to  go  ini.i  titlu'r  one 
or  the  other.     Tiiough  in   the   school   the  lower 
social  class  was  not  j)revente(l  from  rising  to  the 
superior  posts,  il    htness  was  demonstrated,  yet 
the  social  difference  was  not  lost  sight  of.  and  the 
terms  "lady  nurse,"  "lady  probationer,"  and  "ser- 
vant class"  are  found  on  every  page  of  English 
nursing  history  e\en  late  into  the  present  time. 
As  a  res\ilt.  the  nun.es  of  Great  Britain  have  cf)n- 


i86 


A  Ilistur)'  of  Nursing 


slilutrtl  a  \-cTlK'al  mstcail  ni  a  transverse  seetion 
of  siK.'ii't)-.  Tliis  has  luen  frnni  one  standpoint  an 
a<l\"anta<'e,  for  tliere  Ikiac  always  been  women  of 


the  liiuhest  e(hK'ati(in  and  social 


cl; 


iss  at  tlie  tot). 


to  take  hos]iital  pf)sitions,  (hstriet  nursini^^  '.vork, 
amiynursini,M\(irk,and  todireet  and  nri^ranise:  with 
a  jilain,  niediii'ere  l)<>dy  beneath  tluan  to  do  the 
routine  hard  work.  But  it  lias  been  a  (Hsadvanta.^e 
frr)m  another  point  'A'  \de\v.  for  it  has  definitely 
hindered  intellii^eiit  and  loyal  organisation  ainont: 
the  nurses  themseh'es  ithis,  ni  effeet,  h:is  only 
developed  in  recent  years  and  since  a  risint:;  en- 
trance standard  has  leiidied  to  (.■xcludc  an  uM(.du- 
cated  classi  and  so  has  cloi^.ued  the  feet  of  the  more 
l<ublie-s])irited  nu'mlicrs  of  the  nursint:;  profession, 
who,  carJN'  discerning  the  hiiihcr  \ie\\s  of  intelli- 
,L,'ent  (itizensh.ip  as  obh\^ations  o|  a  tnuned  body 
of  workt'rs.  haw  not  ccMSed  to  aspire  to  a  hi.Ljher 
I'ciueational  and  industrial  plane. 

The  .greater  n.itural  dependctiee  of  this  class  may 
ha\-e   Ix'cn   >    le   reason    \\]w  the   earliest    1-audish 


selioois 


alO 


St 


Th 


lomas's  est;dilishi'il   then-own 


])ri\'ate  duty  homes,  wliere  their  nurses,  alter 
complrtioti  of  their  hospital  ser\ico,  were  exiiected 
and  eneoura}.,a'd  to  remain  as  were  the  deaconesses 
in   their  motherhoiiscs,  or  the  nurses  of  the  Conti- 


nent.il 


Cross  .socii 


[iis  m 


heir  associations. 


actually  a  part  of  ;]ic  outfit  of  the  in;4itutioii,  to 


be  rent  I 


lut  as  one  rents  utilities.     Precarious, 


thi 


en,   were  their  opportunities  of  roceivinG;  calls 


f 


ills 


or  hospital  [)osilions  if  ihe\-  est 


ihlishei 


1  themselves 


The  Nightingale  School  for  Xurscs    1S7 


independently,  for  sueh  a  thine:  as  th 


le     CO- 


tive 


■opera- 


or 


aluinn.e    res^nstry    was    then    unk 


While  th 

they  received  a  salary,  \vhile  their  e 


nijwn. 


ey  remained  in  the  service  of  the  hosi)ital 


lori. 


Th 


irnmijs  went 
is  system,   an   inheritance 


to  tile  institut 

l)equeatiied  liy  the  old  monastic  systems,  had  the 


advantaires 


tlK 


monastery — /. 


hom 


securitN'   of 


e  and  support,  and  release  from  the  necessity 


of  seek 


hv^  emjiloyment.     These 


for,  thoui/h  ^\ork  i 


were  stronsj;  points, 


s  iiiL^nified  and  worthw  it  is  often 


hard  and  humiliating:  t 


,0    ( 


x)k 


for  Work.      But  t 


:le 


dit,mify  and   corpora U^  wealth  of  tlie  monastery, 
with  its  amjjle  prox'ision  for  ol,]  ;,!^\',  were  <'-one 


and  in  tlie  a\er; 


.^v  secular  institution  this  system 


too  often 

insufticien! 

and  charit\-.     Had  it 

the  condition  of  n 


''rou,i,dn  in  its  train  a  dependent  old  iv^u, 
ly    i)ro\-ided    for    hy    hospital    ;)cnsions 


hecome  an  endunng  system 


little  better 
Hut,  it 


urses  would  ewntually  have  1 


)een 


in    l-hi,u;lan<]   than   on   the  Continent. 


ma\-  ;iLM! 


n  I 


>e  emphasised,  in  the  '6o's  and 


'70's  it    would    hardh-    1 
furtl 


ia\'e    ln'cn    v 


I>|  '.SSI  I  lie 


o     i.ro 


ler inv 


the 


1  emancipate  the  nurses  completeh' from 


old  form,  and  h,id  the\-  heen  tunv. 


iie  world,  as  is  t 


ail 


prol,al)l\-   ha\e 


)Uhl 


li losi'  into 
'le  modern  nurse,  traininj;  schools 
is!   the  confidence  of  the 


ic. 


W 


now   !roiii 


M 


iss 


.\ 


i"litin''a]t' 


wnt 


nv 


rs  that  she  apj)royed  keepini,'  the  certificated 
nurse  under  the  ,truardi;inship  of  her  school,  chielU- 
"n  the  1,'round  that  she  might  always  have  a  hunie 
where  she  would  be  under  good  influence  and  be 
M'cured  from  the  disintegrating  eflfects  of  a  noni.id 


i88  A  llistof}-  of  Xursiny 


exist L'tice.      I"nr    Miss    Xi'^htiir'alc    hcrsel 


t,     it    is 


without  (luc'Slii';!  that  unly  tlir  ]iuiTst  anil  hii,rlu'St 
ninral  and  i-tliical  standanls  undcrlav  her  stront,^ 
conviction  of  the  necessity  for  [hr  nurse's  thus  H\-- 
iii!^  in  a  home  under  close  i)irinanent  tutelai^a.'  of 
lier  school,  hut  we  nia_\-  tliink  th;,t  she  has  o\-er- 
ideahsed  the  lieiiefits  of  ]iri\ate  nur^ini;  institu- 
tions under  autocratic  control  and  underestimated 
the  value  ot    trie  associatioin  on  a   self-'nAernin" 


Dasis. 


To  the  ext(>nt  tri  wliich  the  Xi^htinyal 


e  sc 


hO' 


oi 


retanied  the  oMcrand  more  militar\'  idiMS  in  this 
respect,  it  lias  ])een  out  of  sym])ath\-  with  the  later 
de\'el<  i|)m  'Ut  of  eoui]ilete  or^'anic  sei)aratii  m  i  if  the 


"raduate  'n  'Ui   her  sehi 


and 


ler  e\oiution  nito 


orLjamsen  sell-i;o\-ernniL;  asscjciations. 

The  reason  for  the  selection  of  vSt.  Thomas's  as  a 
training  i  eld,  was  to  he  foimd  in  the  character  and 
jiersonalitv 
trained   nur-- 


a    \er\-    notahle   wonian   and 


se 


If- 


e,  htlle  known  exeii  to  nianv  of  her 
contemporaries,  and  whose  naiv.e  to-da\-  would 
con\-e>-  no  meaning;  whatever  to  the  '^vviii  army 
of  modi'rn  n'ouu.l:  nurses — so  littk'    lias    the    im- 


irtant  work    w 


iicl 


Ue     (U<! 


lor    nvu'smu    tH.en 


rcmeml'i'r"'!, — Mrs.  W 


min  ipi'",  the  matron  o 


ft! 


le 


hospital.     In   the    early  50's,    .Mrs.    Wardroj 


)er, 


^voman  of  relinen.ient,  havine  1 


lei'ii  U'ft  resiionsihle 


lor  the  care  of  a  little  family,  ap  )lie  1  for  the  p(jst 


twister  ()■•  head  o 


ward  in  St.  Thomas's  hos- 


])ital.  and,  throu,L,'h  tlie  interest 


some  o|    the 


authontu 


s    who 


;ne\\ 


tier, 


receu'cd    tin 


])nst, 


The  Nij^^iting-alc  School  for  Xurscs    1X9 


llmu.L^'h  she  knew  nMihin.t,^  whatever  of  hospital  1 


lie, 


1  he  con-iitKins  already  (iflcii  referre^i  to  were  the 
rule  in  the  hosjiital.  for  the  davs  of  Sairev  Gam 


were  in  full  swin-,^  hut  in  a  remarkal 


.Mrs.  Wanln 


)per  instituted  a  su 


ri)nsinL 


P 

)lv  short  time 


f 


deLrree  o 


order  an 


d  cleanliness,  as    we] 


as    '^(ilinetv. 


Tht 


comimttee, 


seeniL 


and 


a]i])reeiatinL:  the  miprovt. 


ments    she  m; 


ide,  ,L:raduall\-  'M\-e  ln' 


until  fhiallv  she  had  all  tl 


more  power. 


\'ision. 


an 


U'  wards  inider  her  super- 
d  was  ,L,M\a'n  tlie  post  of  matron.  Al- 
thout^'h  re.L,'ular  trainir.j;  was  not  then  t  hou.i^^ht  of, 
yet  lier  seleetion  lA'  eandidates  for  the  positions  of 
diseijiline  ami  influenee,  s\-stem  and  in- 


nurses, 


her 


i^'ence  in   the  eare  of  patients  were  such  that 


tell 

when  the  Council  (if  the  Xij^htinj. 

the  different    Lon 


d.on 


)S 


inak 


ale  rund  \isited 
pitals.    With   a    virw  of 


\n<^  a  selection  for  the  new  school,  St.  Tin 


>mas  s 


irdroper's  rule  was  fovmd  to  he  th' 


under  Mrs.  W 

hcst   mana,i:e<I   a.nd   most   suit.abie,    not    includiif; 

those  under  the  cari'  of  An^jhcan  Sisterhf)ods.  ' 

Althou.L^d;  no  l)io-rai)]i_\-  of  .Mrs.   \VardrMp,.r  has 
heen  writtc'ii,  there  are  man\-  luirses  who  remem- 


ber  her  wt  II.    s 


ome   ot    \\hoin 


h, 


i\-e 


,'linipses  of  her  jHrsonalitw     Thus  Miss  Rich, 
recalled  her  di^nitv,  and  her  hahit  of  al 


;i\"en    httle 


irds 


has 


\\'carmi 


hi- 


'Mo\-cs    on 


iut\- 


and 


case  with  which,  sh 
Isla    Stc'wa!- 


e  ^\rote  with  tlieni 


on. 


wa)-.s 
the 
M 


tin 


pri'S( 


'lit 


th 


o|<, mew- 


matron    o 
1, 


f     St.     H; 


iss 
ir- 


nos])ital.   has    told    ot    the    teelin<'s   of 


awe    with   whu'h    she   contemi)lated    Mrs.    W 


u-d 


I'rui 


n  jTiv^dv  sources  threuf^h  .^Iiss  Diana  K 


itiujvr, 


Tjf! 


IQO 


A  IIi>.U)r\-  of  NursiiiL:- 


ropcT  when,  our  time,  x'isitin.L:  llic  h"s]")il;il  with 
her  f.itlirr,  tlu\  hail  s<<u\e  occasimi  tur  e(in\er.sa^ 
tion,  and  .Mis>  Stewart  wnndered  how  her  father 
could  ])e  so  self-possessed  while  talkinj^'  to  a  v.Minaii 
in  sneh  an  exalted  position,  who  seemed  little  less 
au.uust  than  the  Oueen  herself.  Mrs.  Stron^i,^  in 
I  go  I  wrote : 

For  Mrs.  Wardropcr  I  would  like  to  say  one  word. 
The  sin.i^le-handed  comhat  which  she  undertook  with 
the  general  had  ccnidition  and  the  ij^norance  which  pre- 
vailed at  that  time  in  thenursiii^f  wnrM,  was  hein.L,'  nohly 
fought  when  Miss  Xightingale,  in  search  nf  a  hespital 
wherein  to  estabhsh  a  school  for  the  trahiingof  nurses, 
came  \\])<m  and  recognised  the  good  work  being  done 
l)y  Mrs.  Wardrojicr  and  chose  St.  Thomas's  hospital 
as  the  centre  of  her  operations.' 

Mrs.  \Vardro]X'r  remained  the  head  of  the  Xight- 
in_^ale  school  tor  manv  vcars,  and  Miss  Xi^htins:^ale 
herself  has  left  tln'  I'lillowini;  memorial,  which 
<:;ivcs  an  inimitable  ])ietiire  of  her: 

One  has  passed  away  without  noise,  without  crown 
or  sceptre  <if  martyrdom,  wlio  was  the  y)ioncer  of  hos- 
pital nursing—  the  first  lay  hos])ital  matron,  at  least 
of  a  great  public  hospital-  who  was  a  gentlewoman. 
Her  kingdom  was  that  of  the  sick.  Xo  public-press 
heroine  was  she.  yet  the  countless  sick  will  bless  her 
name  though  they  never  heard  it;  and  she  opened  a 
new  calling  for  women  of  all  classes,  the  nursing  insti- 
tutions for  the  poor.  She  did  this,  a  great  work, 
for  licr  country  an<l  her  sovereign-   thrice  blessed  t" 

'•'The  Prt'paratory  Instruction  of  Nurses,"  Transactions, 
Third  International  Coni;rcss  oj  Xiirses,  Buffalo,  Kjor. 


The  Xi^jhtingalc  School  for  Xurscs    rgi 


those  forwlinni  ii  initiated  a  divine  life  of  common- 
sense  in  nursint,'.  X,,  Mrs.  Gamp  could  live  in  her 
neighbourhood;  Mrs.  Gani].  was  e.Ktiiu  t  forever.  She 
was  soon  gladly  acknowledged  by  the  doctors  as  their 
chief  in  nursing.  She  led  a  hard  life,  but  never  pro- 
claimed it.  Wliat  she  did  was  done  silently.  Xo 
herald  chanted  her  jiraises. 

The  state  of  what  was  l)y  ignorance  called  nurs- 
ing when  she  began  hospital  work,  with  the  miserable 
state,  morally  and  tcchnii'allv.  of  the  nurse,  would 
scarcely  ni.w  be  credited.  Did  one  who  knew  it 
attempt  to  describe  it,  she  would  be  \>y  a  universal 
jury  of  her  fellows  found  guilty  of  e.\aggeratit)n. 

1  saw  her  lirst  in  October,  1854,  wdien  the  expedition 
t.f  nurses  was  sent  to  tlu'  Crimean  War.  She  had  been 
then  nine  months  matron  of  the  great  hospital  in 
London  of  which  for  thirty-three  years  slie  remained 

head    and    reformer    of    the    nursing.     

then  unknown;  the  only  nurse  worthv  of  the 
that  could  be  given  to  that  expedition,  though  several 
were  supjjlied,  was  a  "Sister"  who  had  been  pensioned 
s^me  time  before,  and  wiio  iiroved  invaluable.  I 
^.!\v  her  next  aftcT  the  conclusion  of  the  Crimean 
War.  She  had  already  made  her  mark:  she  had 
Weeded  out  the  inetHcient.  morally  and  technically: 
sl;e  had  obtained  better  women  as  nurses:  she  had 
I'lit  her  tinger  on  some  of  the  most  flagrant  blots, 
"irh  as  the  night  nursing,  and  where  she  lanl  her 
^.;;ger  the  blot  was  diminished  as  far  as  possible,  but 
no  training  had  yet  been  thought  of. 

All  this  led  to  her  being  chosen  to  carry  out,  in  the 
h'spital  of  which  she  was  matron,  the  aim  in  the  train- 
■ri"  of  nurses  of  the  Xightingale  Fund  which  had  then 

!i   subscribed.     She   was   named   first   superinten. 


rainmg    was 
name 


192 


A  Ilistorv  of  Xursinii' 


dent  of  ilio  srhonl.  anil  cnntinucd  smli  "  r  27  vears. 
until  luT  rcMuincnt  in  1SS7.  That  srhoci  imilcr  her 
has  hc'cn  more  or  less  the  model  nt  all  the  subsequent 
nurse  training'  senools,  lA  whii  h  n'lW  nearly  everv 
consiflerahlc  hospital,  and  many  an  im  "nsKkTable. 
has  its  <i\\ii,  hut  they  cliieflx-  tra.in  In;-  theniselves; 
she,  as  head  of  the  .\i,L,duin,^ale  sehool,  trainei]  fur 
many   other   hospitals   ami   inflrnuiries. 

The  ])rinciplcs  of  this  school  may  be  shortly  said 
to  be  as  f(ill<'\vs;  (1)  That  nursi's  diould  have  their 
teehnieal  traiiiinj;  in  hospitals  sijecially  organised  for 
this  purpt;se.  (.')  That  they  should  live  in  a  "home" 
fit  to  form  their  inoral  life  and  discipline.  The  school 
under  this  lady  was  opened  at  the  oM  St.  Thnmas's, 
near  London  Bridge,  in  i860.  St.  Thomas's  ami  tlic 
Nightingale  school  were  renrnved  to  the  Surrey  (lar- 
dens  in  1862,  and  in  1S70  t"  their  present  abode 
opposite  the  houses  of  \':n  lament.  .  .  .  At  the  time 
of  her  retirement  upward  ^f  500  nurses  h.au  c<'m- 
pleted  their  training  ai-.d  entered  into  service  on 
the  staff  of  St.  1  nas's  or  other  hospitals,  and  of 
these  over  50  educated  gentlewomen  were  octafning 
imi)ortant  p(jsts  as  matrons  or  superintendents  of 
nurses  in  hospitals,  infirmaries,  and  nursing  institu- 
tions for  the  poor,  and  not  only  in  the  United  King- 
dom, but  also  abroad. 

It  is  ditficult  to  describe  the  character  of  such  a 
woman— the  more  so  as  her  praises  were  never 
sounded  iit  newspaper  or  book.  .  .  .  Her  power  of 
organisation  or  administration,  her  i^iurage,  and 
discrimination  in  character,  were  alike  remarkable. 
She  was  straightforward,  true,  upright.  She  was 
decided.  Her  judgment  of  character  came  bv  intui- 
tion, at  a  flash,  not  the  result  of  much  weighing  and 


The  Xit^^htingalc  School  for  Nurses   lu 


)3 


consideration ;   yet    she   raulv    made   a    mi.:take,    and 
she    would    take    the    greatest    jiainr,    in    her   written 
delineations  of  cliaracter  required  for  record,  writing 
them  again  and  again  in  order  to  l.e  perfcetlv  just, 
not  smart  or  ele\-er.  but  thev  were  in  exce'Ient   hm- 
guage.     She  was  free  from  se!f-eonseiousness:  nothdig 
artifieial  about  her.     "She  di  1  nothing  because    she 
was   being   looked   at,    and   abstained    from    nothing 
because  she  was   looked  .at."      Her  whole   heart   and 
mind,  Iter  whole  life  and  stretigth  were  in  the  ^'-ork 
siie  had   undertaken.     She  never  went   a-jileasuring, 
seldoiii  into  society      Yet  she  was  one  of  the  wittiest 
people  one  could  hear  on  a  summer's  day,  and  had 
gone  a  great  deal  intcj  society  in  Ikt  young  unmarried 
life.     She  was  left  a  widow  at  42  with  a  young  family. 
She  had  never  had  any  training  in  hospital  life.    There 
was   none   to  be   had.       Her   force  of   character  was 
extraordinary.      Her  word  was  lav,-.     For  Iter  thoughts, 
words,   and  acts  were  all  the  same.     She  moved  in 
one  piece.     She  talked  a  great   deal,   but   she  never 
wasted    herself    in    talking:    she    did    wh.at    she    said. 
Some  people  substitute  words    for   acts:      yhe  never. 
She   knew   what    she    wanted,    and   she    did    it.     She 
was   a   strict    disciplinarian:   \-ery    kind,   often   affec- 
tionate,  rather  than   l"\-ing.     She  took   such   an   in- 
tense interest  in  everything,  even  in  things  matrons 
do   not   generally   consider   their   business,    that   she 
never  tired. 

She  had  great  taste  and  spent  her  own  monev  (for 
the  hospital).  She  was  a  thorough  gentlewoman, 
nothing  mean  or  low  about  her;  magnanimous  and 
generous,  rather  than  courteous. 

.\nd  all  this  was  done  quietly.  Of  late  years  the 
great   nursing  v.ork   h,a>   been   scarred   by   fashion   on 

ViiL     11. 


194  A  History  of  Nursing 

one  side,  and  by  mere  money-getting  on  the  other- 
two  catastrophes  sure  to  happen  when  noise  is  sub- 
stituted for  silent  work.  Few  remember  her  in 
these  express-train  days,  dashing  along  at  60  years 
in  a  day.  "A  perfect  woman,  nobly  planned,  to  warn, 
to  comfort,  and  command";  comfort  not  in  the 
present  meaning  of  comfortable,  easy-chair  life,  but 
comfort  in  the  good  old  meaning  of  "be  strong  with 
me." 

And  so,  dear  Matron,  as  thou  wast  called  so  many 
years,  we  bid  thee  farewell,  and  Godspeed  to  His 
Higher  world.   ..." 

So  marked  a  type  of  the  conscientious  dicta- 
tor and  autocrat  as  tliis  character-picture  shows 
would  obviously  and  neces.sarily  l)e  out  of  touch 
with  many  modern  tendencies.  Mrs.  VVardroper 
was  the  perfect  example  of  the  old-fashioned 
autocratic,  military  matron,  who,  jjcrhaps  through 
the  necessit>-  of  ruling  severely  in  most  cases,  neg- 
lected the  art  of  treating  those  under  her  as  her 
equals  even  when  they  were  .so.  She  was  often 
se\-ere  and  hard  when  it  was  unnecessary,  so  that 
some  of  the  gentlewomen  who  worked  under  her 
could  not  speak  of  her  manner  without  resent- 
ment. She  was  a  convinced  individualist;  be- 
lieved in  class  lines,  and  aimed  ;it  the  preservation 
of  fixed  status;  wisheil  the  Nightingale  nurses 
to  move  in  a  circle  by  themselves,  and  regarded 
the  earliest  movements  toward  a  more  democratic 

'  'Tho  Reform  n{  Sick  Nursing,  and  the  late  Mrs. 
War.lrojit'r."  Hy  Florence  Nightingale.  British  Medunl 
Journal,     Dec.  ji,  i8(ja. 


The  XightinL,Mlc  Sciiool  for  Nurses    195 


(irdtT  with  the  most  intense  (lisai)prol)ation.  Miss 
.\ij;htin5j;ale  shared  these  views,  to  a  certain  extent 
at  least,  thoui,'h  it  is  always  well  to  remember 
that  we  cannot  tell  how  she  would  have  felt  toward 
nr},'anisation  had  she  been  able  to  continue  her 
active  life.  Mrs.  Wardn^per  was  undoubtedly, 
on  some  lines,  conservative  even  to  narrowness; 
and  when,  in  England,  the  first  steps  were  tak^n 
toward  a  professional  equality  and  fraternity  in 
the  formation  of  the  Royal  British  Xurses'  .Asso- 
ciation (whose  history  will  be  considered  in  an- 
other volume),  desifjned  to  bring  nurses  from  all 
schools  together  for  mutual  stimulus,  protection, 
and  progress,  —  ;i  thing  which  was  until  then 
unheard-of  in  the  evolution  f)f  nursing  orders, — 
.Mrs.  Wardroper  regarded  the  movement  as  dan- 
gerous and  subversive  of  proper  .standards,  and 
opi)oscd  it  with  all  her  power.'  Miss  Nightin- 
gale, too,  di.sapproved,  and  urged  the  Nighting.nle 
nur.scs  not  to  enter  into  this  unknown,  and, 
as  it  seemed  then,  revolutionary  union,  which 
threatened  to  undermine  the  authority  and  re- 
strict the  sphere  of  the  matron,  and  to  cut  loose 
the  tics  which  had  heretofore  kept  the  nurse 
closely  related  to  her  school. 

Anomalous    as  such  views  .seem  to-day,  t.^ 
were  very  n.-^tural  then,  for  the  power  of  ideas 
made  the  dependency  of  the  convent  seem  a  hard 

'  St,  Thomas's  nurses  havo  never  formed  an  assf)ciation. 
!>ut  have  an  annual  nunion  at  the  School  and  arc  encouraged 
t'  klip  in  touch  with  it. 


iq6 


A  llislui)  of  Nur.-^ing 


thinj(  for  women  to  br  ak  away  fnnn,  ami  thr 
forms  of  the  convent  still  la\-  nnly  a  very  short 
distance  in  the  past  of  nursinj^;. 

It  was.  j)ossibly,  with  some  such  conservative 
idea  in  mind  that  Miss  Nightingale  wrote  to  nurses 
these  words  ; 

Esprit  dc  corps  should  be  encouraged.  It  is  a 
groat  help  to  tliink.  "It  I  do  this  I  shall  be  a  disgrace 
to  my  training  school"  "If  1  do  that  I  shall  be  an 
honour  to  it."  Let  nurses  be  proud  of  their  alma 
mater.  Let  them  think  their  own  training  school 
and  their  own  doctors  the  first  in  tlie  world.  Let 
there  be  a  friendly  rivalry  with  other  hospitals,  and 
never  try  to  fuse  all  nurses  into  one  mass  -one  in- 
distinguishable mass— of  all  training  schools  or 
hospitals.  If,  liowevcr.  there  has  been  little  or  no 
discipline  in  the  training  school,  then  the  esprit  dc 
corps  will  tend  to  harm,  and  not  to  good.* 

The  benefit  of  esprit  dc  corps  is  more  keenly 
realised  than  ever,  btit  wc  no  longer  feel  that 
widespread  organisation  fuses  all  nurses  in  an 
indistinguishable  mass.  Solidarity,  that  word 
that  means  so  much  to-da>-,  had  no  force  for  the 
members  of  the  older  training  schools. 

It  is  also  well  kr.own  that  Miss  Nightingale  and 
the  matrons  of  that  older  school  have  not  sup- 
ported the  modern  movetrient  for  legal  status. 
though  with  Mi.ss  Nightingale  this  arose  from  a 
belief  that  it  would  check  progress.     She  wrote: 

■  Quain's  Dictionary  oj  Medicine,  etl  of  1894,  Art.,  Train- 
ing 0}  Xiirses. 


The  Nightin,c:alc  School  for  Nurses    197 


Vursint^  is,  above  all,  a  progressive  calling.  Year 
^j  year  nurses  have  to  learn  new  and  improved 
methods,  as  medicine  and  surgery  and  hygiene  im- 
prove. Year  by  year  nurses  are  called  upon  to  do 
more,  and  better,  what  the-  have  done.  It  is  felt 
to  be  impossible  to  have  a  public  register  that  is  not 
a  delusion.  Further,  year  by  year  nursing  needs  to 
be  more  and  mure  of  a  moral  calling* 

It  is,  however,  pos.sible  that,  were  Mis.s  Nightin- 
gale still  out  in  llie  world  of  nurses,  she,  too,  might 
regard  State  examination  not  as  a  public  bureau 
for  certifying  the  personal  character  of  nurses  to 
employers  (which  it  could  never  possibly  be),  but 
as  a  bulwark  (capable,  also,  of  e.\tensi(Mi),  to  pro- 
tect the  fundamentals  of  a  practical  traming  and 
teaching  which  she  with  such  rare  revolutionary 
skill,  courage,  and  success  built  up  after  having 
doomed  the  whole  bad  system  then  existing  to 
e.xtinction.  We  will  recur  to  this  later  in  con- 
sidering her  writings. 

While  .  the  principles  of  nuising.  sanitation, 
hygiene,  and  enlightened  humanitarianism  Miss 
.N'ightingale  may  be  confidenth"  regarded  as.  hu- 
manly speaking,  infallible,  there  is  no  lessening 
of  the  deep  reverence  in  which  she  is  held  to  assume 
that  she  is  not  always  so  when  judging  of  the 
(hanging  social  adjustments  under  which  nurses, 
following  an  inexorable  compulsion,  have  been 
reorganising  their  living  and  working  conditions. 
The  time  of  training  of  the  Nightingale  school 

\rt..  Nursing  llu  Sick.     Quain,  18^4,  Art.,    Trainntg  of 


198 


A  History  of  Xiirsin 


\vas  one  year.  The  ])upils  wcr'  ealled  pr()l)a- 
tioners  durin^^  the  entire  time.  At  the  enil  nt  the 
year,  if  their  record  was  satisfactorx',  thev  were 
entered  in  the  school  register  as  certified  nurses. 
to  be  recommended  for  employment  accordingh 
The  training  was  now  usuall\'  ennsidered  com- 
plete, luit  the  nursr  did  nut  !ea\'e  her  school  and 
become  independent.  On  lier  entrance  the  pro- 
bationer had  agreed  in  remain  in  the  service  of 
the  school  for  three  full  years  after  the  first  year  of 
training:  this  was.  ii.  effect,  a  four  years'  course, 
exce])t  that  cla.ss  and  lecture  instruction  had 
ceasetl  at  the  end  of  t!.c  first  year.  The  nurses 
received  certain  payments  in  moniv-  und  clothing, 
and  after  the  four  years'  service  was  ended  the 
Nightingale  committee  secured  hospital  positions 
for  them  on  salar\-;  but  the  nursrs  wiT(-  imt  al- 
lowe<l  to  make  engagements  except  through  thr 
committee,  nor  to  terminate  one  except  after  three 
months'  notice  to  the  committee.  By  this  ar- 
rangement the  school  carried  out  its  design  of 
training  women  for  hosjiital  work  iirLiinincntly. 

It  is  interesting  to  know  that  the  Nightingale 
.school  for  many  yi-ars  did  not  give  certiticates  to 
its  pupils.     Miss  Nightingale  on  this  p^iint  said: 

We  do  not  give  the  women  a  printed  certificate,  but 
simply  enter  the  names  of  ail  certiticatcil  nurses  in 
the  Register  as  suih.  This  was  done  to  prevent  tlicni 
in  the  ease  of  misconduct  from  using  their  certificate 
improperly.' 

'  Art.  in  .-t.voKii/?  ,j»),/  t'.jpers.  .Metropol.  Workhouses,"  1867. 


The  Xii^htingalc  School  for  Xurscs   i 


99 


This  detail  was  one  which  later  became  out  of 
harmony  with  j'ul.lic  sentiment,  and  certificates 
are  now  j^^ranted  at  the  end  of  th(>  tliree  years' 
course  to  special  probationers,  and  after  four 
years  to  tin-  hospital  nurses.  Loni,'  after  all  the 
other  equally  important  English  ho.spitals  had 
lengthened  to  three  years  the  period  durin.i,'  which 
the  nurse  was  in  trainini,^.  and  l)cfore  she  received 
her  certificate,  St.  Thomas's  retained  its  one  year, 
hut  at  the  ])re.sent  time  its  term  of  trainin,^,  like 
the  others,  is  placed  on  the  hij^'her  l)asis.  St. 
Thomas's  still  recognises  two  classes  of  .students — 

special  or  paying  probationers  [who  must  be  gen- 
tlewomen, and  who  come]  with  the  express  object 
of  entering  the  nursing  profession  permanently  bv 
eventually  filling  superior  situations  in  public  ho.s- 
pitals and  infirmaries,  or  by  nursing  the  poor  at  their 
own  homes  in  Icr  some  organised  sy.stem  of  district 
nursing;  who  pav  a  fee  of  £"30  [about  Si  50] 
and  agree  to  icmain  for  two  years'  service  after  the 
first,  which  is  still  regarded  as  the  year  of  training: 
probationers,  or  women  desirous  of  working  as  hos- 
pital nurses.  Such  probationers  pay  no  fee,  but  con- 
tinue to  receive  certain  wages  and  clothing,  with 
instruction,  during  the  first  year,  and  agree  to  remain 
for  three  further  years  of  service,  on  salary.' 

As,  contrary  to  the  earlier  custom,  these  two 
classes  of  pu])ils  now  receive  certificates,  and  as 
these  are  not  given  to  them  until  the  termination 

"f.  respoctivolv,  the  three  an.i  four  years*  course 

'  Rcguialions. 


200 


A  llislory  of  Nursin 


to  which  tlu'V  bind  tlicmsrh-i-s,  this  pcritvl  in;iv 
be  regarded  as  a  time  (>f  pupilage,  or  training  term 
of  three  and  four  years. ' 

The  theoretical  teaching  ■was  in  the  form  of 
lectures,  prescribed  reading,  and  examination  by 
the  meihcal  lecturers,  b..c  before  all  else  Miss 
Nightingale  insisted  upon  tlie  culti\ation  of  the 
observation  and  reflection  by  written  notes  of 
cases,  of  work  and  procedures.     She  says: 

To  triiln  to  train  needs  a  system  —  a  systematic 
course  of  reading,  laid  down  by  the  medical  instructor, 
hours  of  study  (say  two  afternoons  a  week),  regular 
examinations  by  liim,  themselves  cultivating  their 
own  powers  ui  expression  in  answering  him. 

Those  who  have  to  train  others  are  the  future 
leaders,  and  this  nuist  be  borne  in  mind  during  their 
year's  training. 

Careful  notes  of  lectures,  careful  notes  of  type 
cases,  and  of  cases  interesting  from  being  not  types 
but  unus'.al.  must  be  kept  by  them;  their  powers  of 
observation  must  be  improved  in  every  way. 

To  illustrate  the  cases  they  are  nursing  in  the 
wards,  descriptions  of  these  cases  must  be  pointed 
out  to  them  at  the  time  in  the  books  in  their  library 

They  must  be  encouraged  to  jot  down  afterwards, 
but  while  still  fresh  in  the  memory,  the  remarks 
made  by  the  physicians  and  surgeons  to  their  students 
in  going  their  rounds. 

They  must  be  taught,  both  by  the  ward  Sisters  and 

'  St.  Thomas's  hosiMlal  <loes  not  give  its  nurses  a  pension, 
but  providfs  many  {)t.Tniancnt  jjositions,  with  good  con- 
ditions. The  nurses  average  ten  years'  stay  there.  Blue 
Book,  "  Metrojiolitan  Hospitals."  iSqo,  p.  91. 


rhc  Nightingale  School  for  Nurses   -oi 


the  medical  instructor,  to  know  not  only  symptoms 
and  what  is  to  be  done,  but  to  know  the  "reason 
why"  of  such  symptoms,  and  zc'hy  such  and  such  a 
thing  is  done.  Else,  how  can  they  train  others  to 
know    tne    "reason    why"? 

Time  must  be  ji;iven  tiicm  for  this,  otherwise  thev 
are  too  likely  to  degenerate  into  drvdgcry  in  the 
wards. 

They  must  write  out  their  jottings  afterward  in 
the  home.i 

While  the  attitude  of  the  medical  profession 
towards  the  new  teachin(f  nnist  ha\-e  been  on  the 
whole  cordial  (or  it  could  not  have  been  carried 
on),  yet  the  perennial  objector  did  not  fail  to  rise 
up  in  thi'  i)crs.  >ii  of  Dr.  La  Garde,  who,  in  ;in  ad- 
dress on  "  Xur.sini(Sisterhoods  and  I  los])it,d  Schools 
for  Nurses"  resjjarded  with  alarm  this  (lans.^erous 
tendency  to  communicate  prf.'fe.ssional  kno\vledjj;e 
of  a  technical  sort  to  the  nurse,  whose  proper 
standini;;  he  summed  u])as  follows: 

A  nurse  is  a  confidential  ser^-ant;  but  still  only  a 
servant.  She  shouM  be  middle-aged  when  slie  be- 
gins nursing;  and  if  somewhat  tamed  by  marriage 
and  the  troubles  of  a  family  so  much  the  better. 

The  medical  instruction  of  Ihe  early  .schools, 
however,  was,  in  tlie  opinion  of  Dr.  Gill  Wylie,  who 
visited  St.  Thomas's  in  1872,  not  alarmini,dy  com- 
plicated. He  wrote  an  account  of  his  visit  and 
impressions  which  is  very  lifelike: 

'  From  tile  article  on  tt.iininjj  in  Atcoimts  and  Papers, 
"  Metropolitan  Workhouses  "  1S67. 


:o-^ 


A  History  of  Nursin-- 


Durini^  tb.e  three  weeks'  stay  in  Lnnilnn,  my  lodg- 
ins's  were  in  .St.  Thomas's  Hospital.  Mrs.  Warciroper 
ha  l)oen  matron  of  this  hosjjital  of  600  beds  for  eij,'ht- 
cnn  years.  She  is  also  lady  superintendent  of  the 
.\'i,L;htin,i;aic  trainini;  srlioul  f(ir  nurses,  and  fulfils 
the  varied  duties  of  these  positions  in  the  most 
satisfactory  manner.  Althouj^di  much  occupied,  she 
was  verv  kind  in  .^ixinj;  me  information,  and  allow- 
in;.,'  me  everv  advantage  for  studying  the  system  of 
trainmg. 

The  arrangcmenis  for  the  nursing  stall  are  as  fol- 
lows: There  arc  in  all  16  hospital  Sisters  or  head 
nurses,  one  of  whom  acts  as  supcrintcu'lent  I'f  night 
nurses  and  one  as  matron's  assistant.  There  are 
fiftv-four  nurses  ami  three  nursemaids;  to  five  of  the 
head  nurses  are  assigned  two  wards  each;  to  seven, 
one  each,  and  tliere  is  one  Sister  for  the  infectious 
block'  for  every  large  ward  tlicre  is  one  day  nurse 
and  one  night  nurse. 

There  are  23  wardmaids.  and  for  the  cleaning  "t 
tlic  stairs  and  cnn'idors,  anti  the  general  wnrk  nui- 
side  the  wards,  14  scrubbers.  Such  nurses  as  have 
charge  of  a  ward  sleep  in  their  own  rooms  adjoining 
their  respective  wards;  and  the  other  nurses  and  ward- 
maids  sleep  on  the  attic  floor  ^  l'  the  bluck  in  which 
their  respective  wards  are  situated.  Each  nurse  has 
a  bedroom  to  herself. 

The  probationers  are  employed  as  assistant  nurses 
und.LT  the  immetliate  din.  tion  <<\  the  head  nurses. 
As  a  general  rule  tw(j  are  assigned  to  each  medical  and 
surgical  ward;  occasionally,  according  to  the  neces- 
sities of  the  case,  three  to  one  ward  and  one  to  an- 
other; thev  are  not  cmjiloyed  in  the  infectiiais  wards. 
They  pass,   during  the   year's  training,   successively 


Tiic  .\i-^htinL;alc  Scliool  for  Nurses   2 


03 


through  all  the  dilTcrcnt  wards,  t-xci'iit  those  of  the 
infectious  blofk.  Tiiose  who  arc  qiialified  arc  cin- 
ytloyed  to  take  tiic  places  of  the  other  nurses  durini,' 
illness  or  teni])orary  absence. 

i'roin  this  it  is  seen  that  to  about  tliirtv  patients 
there  is  one  head  nurse,  one  da\-  luirse.  one  ni;.,dit 
nurse,  two  proliationer-assistants,  and  one  ward  maid. 

As  to  the  instructions  given  outside  the  wards,  a 
few  lectures  are  delivered  each  season  by  Hr.  Pea- 
cock, on  principles  of  medicine;  b\-  .Mr.  Lc  Ciros  Clark, 
on  surgical  subjects;  and  Dr.  Bernays,  on  chemistry 
and  the  properties  of  air  and  light.  All  of  these  are 
men  of  reputation,  being  visiting  physicians  to  the 
Ii'-sjiilal  and  jirofcssors  in  tlic  medical  (-ollegc.  While 
the  lectures  are  being  ilelivercd  the  i)robationers 
take  notes,  and  afterwards  write  out  tlic  lectures.  I 
examined  eight  or  nine  of  the  best  written.  In  most 
"I  them  the  subjects  were  treated  in  the  sim].lest 
style.  Mr.  Clark  himself  told  me  that  he  merely 
.eave  thent  a  talk,  tellmg  them  what  they  should  not 
'■  ',  rather  tlian  anything  else.  The  lectures  are  too 
few  in  nmiiber  and  not  .at  all  systt^matiscd.  It  seems 
t"  me  that  to  take  a  woman  or  man  at  the  age  of  _^o 
v.ith  only  a  common  education  as  a  basis,  and  teach 
■  'em  science  by  lectures,  is  a  doubtful  ex])eriment ; 
ami  that  if  attempted  ;it  all  it  sliould  \>v  ]>v  men  v,  ho 
have  the  time  to  make  the  course  of  instruction  a 
sjiecial  study.' 

The  general  fcatttrcs  nf  hosjiital  life  and  ntirsing 
arrangenient.s  at  tlu'  time  that  Mi.ss  .Xii'htiiiLrale's 


'  Report  to  the  J  raining  Sciiool  Committee  of  BelU-rue  !!os- 
'^■^•il.  1872. 


204 


A  History-  of  Xursini^ 


reformation  was  set  in  motion  rire  \'c'ry  jjjraphicaliy 
described  in  the  British  Medical  J iHirual  in  a  seriis 
of  reports  by  a  special  commissioner,  who  com- 
pared the  conditions  of  his  day  (1S74)  with  those 
of  twenty  years  earlier.  Thrn  (.1S54)  tlie  a\-era<,re 
metropoHtan  hospital  had  three  classes  of  nurses: 
head  nurses,  nurses,  under  nurses.  It  was  pos- 
sible, under  the  system  of  promotion  prevailing, 
f(  ir  th(>  under  nurses  to  l)ecome  head  nurses.  There 
was  no  uniform  dress,  and  (what  modern  nurse- 
pupils  w  -•  Id  do  well  to  note)  besides  a  salary  each 
nurse  reveived  eij^ht  shiUintrs  a  week  in  place 
of  board.  They  cooked  their  fnod  (which  they 
bou.<,'ht  for  them.selves)  and  ate  their  meals  in  the 
ward  kitchens  or  scullery.  The  assistant  nurses 
had  the  cookinj^  to  do  for  the  head  nurses  and  the 
patients  as  well  as  for  thenisehes.  The  ni^ht 
nurses  were  on  duty  fr(_)m  10  i'.  m.  to  i  i'.  m.,  or 
fifteen  hours.  They  occasionally  had  a  leave  of 
absence  for  afternoon  and  evenint^,  but  were  on 
duty  at  ten  as  usual;  on  these  occasions  being  u]) 
for  about  forty  hours  at  ;i  streti'h.  The  matron 
v/as  someone  \\\\n  jierhaps  had  been  nurse  or 
house-keeper  to  some  inlluential  governor.  She 
is  descrilied  as  having  been  usually  a  stout  lady 
with  an  authoritative  voice  and  v/onderful  cap. 
The  he. id  nurses  were,  in  their  wards,  practically 
independent  of  her,  and  their  loyalty  was  prin- 
cipally shown  by  imitating  her  cap.  But  that 
there  were  ])ersonalities  of  value  among  the  old- 
style  nurses  is  recorded  by  Sir  James  Paget,  who 


The  Xightiii^L^.iIt'  School  for  Xnrscs  2 


Q: 


!i.is  left  rccollfviions  of  sonu'  of  thi'  old  nurses  at 
St    Bartholomew's. 

■'  It  is  true  [he  writes]  that  even  fifty  years  apo  there 
were  some  excellent  nurses,  especiallv  amonp  the 
Sisters  in  the  medical  wards,  where  e^  erN-f'liin-  was  more 
k-entle  and  orderly  than  in  the  sure,'!,  a  1.'  There  was  an 
admirable  Sister  Hope,  who  had  her  le-  amputated 
and  then  devoted  her  life  to  nursing  there. 

An  old  Sister  Rahere  was  the  chief  amonjj  them. 
-"Ut,  ruddy,  pf)sitivc,  very  watchful.  She  once 
taught  an  erring  house  surgeon  where  and  how  to  com- 
press a  posterior  tibial  artery.  She  could  always 
report  correctly  the  progress  of  a  case;  and  frrm:  lier 
wa^-es  she  saved  all  slie  could  and  left  it  in  legacy  to 
the  hospital.' 

The  customs  relatin.ij  to  board  and  waives  were 
"f  lotig  standino^.  but  had  varied  a  httlc  in  different 
hospitals.     St.  Baaholomew's  had  paid  its  Sisters 
an  avera^^e  of  si.xteen  shilHngs  a  week,  and  they 
provided  their  own   fe>od.      The  nursJs  recei\-ed 
one   shilling  and  twelve  ounces  of  bread   <huW. 
St.  Thomas's  gave  its    Sisters   ^37    a   vear;    the 
nurses  had  q  shillings   7   pence  a  week,  "and  beer. 
(iuys  hospital  paid  its  Sisters  and  nurses  better 
than  any,  but  at  none  of  the  three  dv  1  they  receive 
an\-  food  beyond  that  mentioned,  nor  were  their 
wages  increased   by  length  of    ser\-ice.      At    St. 
George's  all  the  nurses  were  allowed  six  pounds  of 
hrcad  a  week,  one  h.ilf  pint  of  milk  and  two  pints 

■foKoirs   and    I.ritcrs    oj   Sir    James    Pa^ct.  Loiiijiuaus. 
^•^'■::\  ic  Lo.,  London,   1901.  p.  353. 


2o6 


A  I  li-^loiv  of  Nuisin'^ 


ot 


lic'cr  (lailv,  and  out'  s 


hillini:  ri  dav  lo  tuiv  addi- 


ti'inal  food  (board  and  wai 


1 


The  c'xain])lc  of  tlie  Xi<,fhtin<,fale  school,  tri- 
tuiiphantly  made,  \vas  in  time  followed  by  every 
other  English  hospital  of  importanee.  One  by 
one  thev  gave  up  the  old  system  of  nursing  ffir  the 
new,  and  the  English  colonies  an.l  thr  I'nitr'i 
vStates  followed  the  lead.  As  tinir  went  on  it  was 
not  always  easy  to  keep  the  ranks  recruited  in 
sufficient  numbers  to  fill  all  the  demands  of  hos- 
pital service,  and  a  feature  peculiar  to  English 
hospital  life  appeared  in  the  "lady  probationer." 
The  ladv  ])robationer  came  for  a  term  of  from 
three  to  si.x  months'  training,  pa\-ing  a  fee  for  her 
tuition,  and  had  rather  special  privileges  in  that 
she  was  allowed  to  slip  owr  more  laborious  and 
..lutine  parts  of  ward  work  and  to  attain  superi'ir 
posts  by  virtue  of  hiM"  education,  intelli.L;ence,  ami 
social  position  instead  of  as  the  result  of  the  Ion;;, 
hard  time  of  training.  She  was  only  a  transient 
figure,  and  has  to-day  almo.st  entirely  disappeared 
from  English  ho.spitals.^ 

'  History  of  the  Middlesex  Hospital,  p.  117. 
'Sec  cvidemo  on     '  p.iying  jjrobationcrs  "    in  Blue  Book, 
Metropolitan  Hospitals,  1890,  p.  aoj. 


iiyale  Ilv.un:  ami   I'raiiiiiii'  Scliuoi  fur  \ 


r  Nur-cb,  St.  T 


ioiiiav\  II, 


)-liU.ll 


(MIAPTI'R  V 


MISS  xic,irn\(;.\iJ:s  writixgs 


GUlvAT  ;is  Miss  XiL^lit inhale  was  as  a  nurse, 
Ikt  mirsiiis^r  rrtlcclcil  onh'  a  ])art  oi  luT 
jjLiiius.  Shr  was,  ])rrhai)s,  wcu  ^rratrr  as  a 
teacher,  ami  wiihoul  a  'ioubt  .greatest  as  a  sani- 
tarian. Thou<,'h  it  was  by  her  nursing'  that  j>lie 
seized  ami  tiel'l  the  hearts  aiii!  inia.i^inations  of 
men — so  that  thnsewh'i  knnw  iiiithiiii,^  furtlier  of 
her  know  that  she  was  the  lu'nii'u-  >  it"  tlie  C'riniea 
an<l  the  reformer  of  nursuii,',  it  is  the  intelleetual 
quality  of  her  deej)  insii,'ht  into  jimMeins  of  health 
that  keeps  her  work  and  will  alw.ess  keep  it  fresh 
anil  vivid.  It  is  imt  p.  issihle  to  study  lu  r  writ- 
ings without  heint^  stron.^h-  stirred  li\  In  r  ardriit 
realisation  of  ;i'l  that  makes  fur  lualtli  She  was 
an  enthusiast  for  health  and  happiness.  Sai;' 
Dr.  Hlackwell,  '  /  <i  lur  ehiell}-  I  owe  the  awaken- 
iny[  to  the  fact  that  sattitatiott  is  the  supreme  goal 
of  me'licine,  its  fojndation  and  its  erown."  Tn 
considering,'  her  practical  and  technical  knowledj^'e, 
so  extensive,  so  minute,  so  exact,  and  above  all 
so  intillijjent  is  it  found  to  be  that  it  is  perha])s 
not  tiH)  much  to  call  her  the  foremost  sanitarian 

207 


-If.-^:^. 


:oS 


A  History  of  Nursing 


of  her  3^e,  as  unitin-,'  in  a  rare  measure  technical 
knowledK'c  u-ith  or^ranisin^'  capacity.  Practical 
h\--iene  underlay  .11  her  teachin-s  tiirouj^^hout  her 
l"n,cT  lit;..  l,c-)nnin-  with  h.  .  imlividual  visits  in 
the  C()tta,t,'es  near  her  cou-'     v  home. 

A  very  remarkal.Ie  exami)le  of  the  ori,<,nnah'lv 
of  this  teaching   js   i^t  Xolcs  on  Xitr^iui^;    \Vlu,t 
It   Is,   and   Wnat   It   Is  Xot.       In    this   unrivalled 
tnonoKraph  she  does  not  concern  ht>rself  with  s,» 
nuKdi  as  a  .ulanee  at  the  carryin-  out  of  "  orders  "  in 
the  application  of  treatment,  nor  describe  a  single 
method  r,f  technical  procedure,   nor  hint  at  the 
relation  of  the  nurse  to  the  patient,  the  physician 
the  lamil:/,  nor  <lescrihe  the  symptoms  of  a  single 
<lisease,  not-  outline  the  special  nursini,' care  of  any 
•special  case.    That  ^yhich  makes  thus  book  an  ini- 
Tnortal  classic  is  its  teaching  of  sanitarv  truths  and 
pnnciples  as  applied  in  the  care  of  sickness,  and 
"t  a  boundless  and  e.x(iuisite  humaneness  to\vards 
tlie  patMit:  principles   uhieh  will  never  (diange. 
while     prncciurc's,     profrssi,  ,nal     etiijuette,     and 
methods  will,      h,  its  presentation  of  the.se  truths 
and   the  praet    -al    applieation   made  of  them,   it 
stands     uniiue.     unapproached.     and     cmplete 
In  selecting   quotations   ficm   the   Xotcs  we  are 
impressed    afresh    with    its    rare    characteristics, 
and  are  imi)ellc.d   to  urge  uj.o,,   every  uoman- 
not  only  every  nurse,  but  every  woman  n  ho  reads 
these  words— to  possess  herself  of  it  and  make  its 
teaching  a  part  of  her  mental  equipment. 

In  uatching  disease,  both  in  private  houses  and  in 


Miss  Xightingalc's  Writings 


209 


pubhc  hospitals,  the  thinj?  which  strikes  the  experi- 
enced observer  most  forcibly  is  this,  that  the  symptoms 
-T  the  sufferings  generally  considered  to  be  iney- 
itable.  and  incident  to  the  disease,  are  verv  often  not 
svmptoms  of  the  disease  at  ail.  but  of  something  quite 
ditierent— t)f  the  want  of  fresh  air.  ,t  of  h\rht  .,r  of 
warmth,  or  of  quiet,  or  of  cleanliness,  or  of  punctuahty 
and  care  in  the  administrati..n  u{  diet,  of  each  or  of  all 
..f  these.  And  this  quite  as  much  in  private  as  in 
hospital  nursing. 

The  reparative  process  which  Xature  has  instituted 
and  uhich  we  call  disease,  has  been  hinucred  bv  some 
want  of  knowledge  or  attention,  in  one  <.r  in  all  of 
these  things,  and  pain,  suffering,  or  intcrrui^tion  of  the 
whnle  process  sets  in. 

If  a  patient  is  cold,  if  a  patient  is  feverish,  if  a  pa- 
tient  IS  faint,  if  he  is  sick  after  taking  f(K.<i.  if  he  has 
a  bed-sore,  it  is  generally  the  fault,  n<.t  of  the  disease, 
but  "t  tlie  nursing. 

I  use  the  word  nursing  fur  want  of  a  better  It  his 
been  limited  to  signify  httie  more  than  the  adminis- 
tration of  medicines  and  the  application  of  poultices 
It  ought  to  signify  the  proper  use  of  fresh  air,  light 
warmth,  cleanliness,  .piiet,  an,l  the  ;.rr,per  selection 
and  administration  of  diet  ail  at  the  least  expense  of 
Vita!  power  to  the  yiatient. 

It  has  b..rn  said  and  written  scores  of  tinirs  that 
every  woman  makes  a  good  nurse.  I  believe,  .,n  tiie 
■■■"itrary.  that  the  very  elements  of  nursing  are  all 
'''•i!  unknown.   .   . 

The  art  of  nursing,  as  now  practised,  seems  t<.  be 
•^xpressly  constituted  to  unmake  what  God  had  made 
'iiMase  to  be.  viz..  a  reparative  process.  ...  If  we 
^urc  asked.  Is  .such  or  such  a  disease  a  n-parative 

VOt.  II. 14. 


2  lO 


A  History  of  Xursini^ 


process'  Can  siuli  an  illness  l»c  unaccompanied  with 
suffcrinK.'  Will  an_\-  care  prc\c;nt  siu'li  a  ]  .itiint  fn.ni 
sufTcrin.i,'  this  -.r  that-  -I  huniMy  say,  I  do  not  know. 
Bin  when  y-u  have  done  away  with  all  that  jiain  and 
suilcrin-,  whiih  u,  j.aticnt.s  arc  tlic  syniptnms,  not  .if 
their  disease,  but  of  the  absence  of  one  (ir  all  of  the 
above-mentioned  essentials  to  the  success  of  Nature's 
rejiarative  process,  we  shall  then  know  what  are  the 
symptoms  of  and  the  sulicrinj^js  insej-arable  from  the 
disease.  .   .  . 

.  .  .  The  very  elements  of  what  constitutes  ^^  A 
nursini,'  are  as  little  undcrstoo<l  fm-  the  wdl  as  for  tiie 
sick.  Tlic  same  laws  of  health,  <-v  of  nursin.LT.  for  th(  v 
are  in  reality  the  same,  obtain  amonj;  the  well  as  auK  .ryy 
the  sick.  The  breaking,'  of  them  produces  onlv  a  less 
violent  consequence  amon-.;  the  former  than  anting  the 
latter,  — and  this  sometiini's.  n.  ■!  alwavs.  .  .  .  O  mothers 
of  families,  do  you  know  that  one  of  every  seven  infants 
in  this  civilised  land  of  Englam!  perishes  before  it  is  one 
year  old?  That  in  London  two  in  every  five  die  before 
they  are  live  years  old.'  An<i  in  the  otiicr  great  cities 
of  England,  nearly  one  out  of  two?  "'j'h.c  life  durati.  n 
<if  tender  babies*'  (as  some  Saturn,  turned  analyt- 
ical chetiiist,  says)  "is  tlie  tnost  delicate  test"  of  sani- 
tary conditions.  Is  all  this  premature  suffering  ami 
<leath  necessary?  Or  did  Xature  intend  mothers  to 
be  always  accompanieii  i)y  doctors?  Or  is  it  better 
to  learn  the  pianoforte  than  to  learn  the  laws  which 
subserve  the  preservation  of  ofTspring? 

The  very  fiist  canon  of  nursing,  the  first  and  the 
last  thing.  ui}on  which  a  nurse's  attention  must  he 
<ixcd.  the  first  essential  to  a  patient,  without  which 
all  the  rest  you  can  do  for  him  is  as  nothing,  with 
which.  I  had  almost  said,  you  may  leave  all  the  rest 


Miss  Xi-htin^ralc's  Writ 


in^s 


1 1 


al.:nc,  is  this;    to   keep  the  air  he  hrcatlics  as  pure  as 
tin-  external  air,  leithnut  ehilliui^  l,i,r..      W-i,  what  is  s-. 
lit-lc  attriKk.!   x,ri      Hvin   where  it  is  ihou-ht  of  at 
all.    the    inc.st    extra- -rdinarv    niisomeei.ti,  ,„s    rci,t,'n 
about  It.      Even  in  admitting  air  into  the  patient's 
n.om  or  ward  fe-,v  ,,eoplc  exer  think  where  that  air 
cnines  from.      It  may  eonie  Innn  a  corridor  into  which 
(-ther  wards  arc  ventilated,   fmm  a  hall  always  un- 
aircd,  always  full  of  the  fumes  of  .sjas.  .linncr.  o'f  vari- 
<'us  kinds  of  mustincss;  fmm  an  undcr-rMund  kitchen 
sink,    washliouse,  w;iter-el,)set.  or  even,   as    I    my.self 
I'.ave    had    sorrowful    experience,    from    oj.en    sewers 
loaded  with  filth;  and  with  this  the  patienfs  room 
..r  uard  is  aired,  as  it  is  called-pois-me.l,  it  should 
rather  be  said.   .   .   .   Xever   be   afraid   of   ,,j„.t,  win- 
dows, then.      Pe-,plc  <ion't  eateh  cold  i„  l,,-,]       Th-'s  is 
a  popular    falla.y.   .   .   .   Dr.    —      's    air    test,   if   it 
could  be  inade  of  simple  applieati.ni.  w.aild  be  inval- 
uable to  use  in  every  sleepinj^r-  and   siek-room. 

An.l  O,  the  crow.led  national  school,  where  so  many 
children's  cindcmics  have  their  ori^'in,  wliat  a  tale  an 
air-tost  woul.l  fil'  Wc  should  have-  paivnts  savint; 
and  sayinf,'  ri.i,ditly.  'I  will  not  sr„,|  mv  chiM  to'that 
school,  the  air-te.st  stands  at  'Horrid.'"  And  the 
'iormitories  of  our  .threat  l)oarding-schoolsl  Scarlet 
fever  would  be  no  more  ascribed  to  contagion,  but  to 
Its  ri^ht  cause,  the  air-test  standinjj  at  " Foul." 

The  extraordinary  confusion  between  cld  air  and 
ventilation  even  in  the  min.ls  of  wdl-educate.l  jioople 
>  !t'strates  this.  To  make  a  room  cold  is  bv  no  means 
•-cessary  to  vent, Late  it.  Xor  is  it  at  all  necessarv 
to  ventilate  a  room,  to  chill  it.  .  .  .  Another  extra- 
•■  !'.nary  fallicv  is  the  <lrcad  of  th.-  ni.-rht  ai-.  What 
■"'•  can  we  brcalJic  ut  nigiii  but  night  air?     The  ch...ice 


2  12 


A  History  of  Nursiinj 


is  h(>twecn  inirc  niLrht  ;iir  frnm  with'iut  and  t-iul  nipht 
air  from  within.  Must  pcnjilf  prefer  the  latter.  An 
miaecmmtalde  t'hniec.  What  will  Mio\-  say  if  it  is 
l)roved  to  he  true  tliat  tull\-  one  half  of  all  the  disease 
we  suffer  from  is  occasioncil  1'}'  peoj.lc  sleeping'  with 
tlu'ir  windows  shut ' 


It  a  nurse  declines  to  do  these  things  for  her  patient, 
"because  it  is  not  her  business,"  I  should  sav  that 
nursin.t,^  was  not  her  calling.  I  have  seen  surpieal 
"Sisters,"  women  whose  h.ands  were  worth  to  them 
two  or  three  Lruine.as  a  week,  down  upon  their  knees 
srourinj.^  a  r^  ".m  or  !uu.  because  they  thou.L,dU  it  other- 
wise not  (it  for  then-  p.atients  to  <^,,  into.  I  am  far 
from  wishin;^'  nurses  to  scour.  It  is  a  waste  of  power. 
But  I  do  say  that  these  wotren  had  the  true  nursinj,' 
eallin.[^— the  j^ood  of  tluir  si(  k  first,  and  secr,nd  only 
the  consideration  wdiat  it  was  their  "place"  to  do;  — 
ami  that  women  wdio  wait  for  the  housemaid  to  do 
this,  or  for  the  charwoman  to  do  that,  when  their  pa- 
tients are  sulTerinL;,  have  not  yet  t!ie  maki^ig  of  a  nurse 
in  them. 


Is  it  not  livin.i;:  in  a  continual  mistake  to  look  upon 
diseases,  as  we  do  now,  as  sejiarate  entities,  which 
must  exist,  like  cats  and  do^'s,  instead  of  looking 
upon  them  as  conditions,  like  a  dirty  and  a  clean  con- 
dition, and  just  as  much  under  our  own  control,  or 
rather  as  the  reactions  of  a  kindly  n.iture  apainst  the 
conditions  in  which  we  have  placed  ourselves? 

I  was  brought  uj'.  both  by  scientific  men  and  ignu- 


Miss  NiL^htingalc's  W'ritino-s 


rant  women,  di^iinctly  t')  believe  that  small-pox,  fur 
instance,  was  a  tiiint,^  ,,f  which  there  was  once  a  first 
specimen  in  tiie  worhl,  wliieh  went  (.n  i)r()i>aj,'atins 
itself,  in  a  [.erjictual  chain  of  descent,  just  as  much 
as  that  there  was  a  first  do^;  (or  i)air  of  dopsV  and  that 
smail-j)ox  w.aild  not  bcpn  of  itself  any  nK.re  than  a 
new  do.,'  would  !,c-in  without  there  having  Leon  a 
parent  dog. 

Since  then  I  have  seen  with  my  own  eyes  and  smelt 
with  my  nose  small-pox  growin.L,'  up  in  first  sjieeimens, 
either  in  close  rooms  or  in  overcrowded  wards,  where 
it  could  not  by  any  possibility  have  been  "  ;iu<,dit," 
but  must  have  be.[rim. 

Xay,  more,  I  have  seen  diseases  be.uin,  .I'row  up, 
and  iiass  into  one  another.  Xow,  do.s^s  do  not  pass 
into  cats. 

I  have  seen,  for  instance,  with  a  little  overcrowd- 
in,!,'.  continued  fever  j.:row  up:  an<i  with  a  little  more, 
typhoid  fever:  and  with  a  little  more,  tyi)hus,  and  all 
in  the  same  ward  or  hut. 

Would  it  not  be  far  better,  truer,  and  more  practi- 
cal, U  we  l-okcd  up,,n  diseases  in  this  lii^ht :'  For  dis- 
eases, as  all  experience  shows,  are  adjectives,  not 
noun  substantives. 


There  are  five  essential  jioints  in  securini;  the 
health  of  houses:  i.  Pure  air.  2.  Pure  wattT.  5 
Ktficient  drainai:c.  4.  Cleanliness.  5.  Light.  G(mI 
lays  down  certain  physical  laws.  Upon  His  carrying 
out  such  laws  depends  our  responsibililv  (that  much 
abused  word);  for  how  could  we  have  any  resp.msi- 
I'ility  for  actions  the  results  of  which  we  could  not 
ft-resee?— which   would   be    the    case   if  the  carrying 


4 


A  History  of  XursiiiL'' 


nut  'tf  TTis  law'^  were  v.n[  certain,  \\\  v:c  sec  in  to  be 
cnntimially  rxjicftiii.L:  ll'at  Uv  v.\]\  wurk  a  miracle, 
I.e.,  break  Ili^;  own  laws  cx]>rcssly  to  relieve  us  of 
re<i>nnsibiliiy. 

5.  A  (lark  liousc  is  always  an  unhealthy  house, 
always  an  unaired  house,  always  a  dirty  house.  Wain 
of  li^'ht  sto]'s  i^rowtli.  ami  jir./inotes  scrofula,  rickets, 
etc.,  anion.r,'  the  children. 

Fc()['lo  lose  their  health  in  a  dark  house,  and  if  they 
,s:;et  ill,  they  cannot  <;et  well  ai:ain  in  it. 

Don't  ima-ine  that  if  you.  uho  are  in  ( hari^c,  don't 
look  to  all  these  thinjjjs  yourself,  those  under  you  will 
be  ni'.re  careful  than  ytm  are.  It  ap{)ears  as  if  the 
part  of  a  mistress  now  is  to  complain  of  her  servants, 
and  to  .'icci'pt  their  excuses — not  to  show  them  ln.w 
there  need  be  neither  t'onijilaints  made  nor  excuses. 

Hut  a'^'aiii.  to  look  to  all  these  thin.c^s  yourself  docs 
not  mean  to  Jo  them  yourself.  "  I  alwavs  open  the 
windows,"  the  luad  in  (  Ii.TLre  often  says.  If  \-ou  do 
it.  it  is  by  so  much  the  bitter,  certaitilv.  than  if  it  were 
HMt  d<,ne  at  all.  Hut  can  you  noi  insure  tnat  it  is 
done  when  not  d-.ne  by  yourself'  Cun  vou  insure 
that  it  is  not  unilone  when  your  back  is  tuiMud.'  This 
is  what  "bein.L.;  in  charj,'e"  means.  And  a  \-ery  im- 
I'ortant  meaning,'  it  is,  tor).  The  foriner  onlv  implies 
that  just  wh.it  y./u  can  do  with  y-ur  own  hands  is 
done.  Tlie  hitter,  that  what  ou_^ht  to  be  done  is 
always  done. 

Wise  and  humane  mana,i:enient  of  the  jiatient  is  tlie 
be  t  safeguard  against  infection. 


Miss  Xi<^htinnraK''s  W'ritin  ■> 


2  I 


Tiiere  arc  not  a  ivw  popular  oj)ini()ns  in  rctjard 
in  which  it  is  useful  at  times  to  ask  a  question  or 
tv.--..  Fnr  example,  it  is  commonly  th-iu-ht  tliat 
children  must  have  what  are  c.immdnlv  calKd  "chil- 
dren's epidemics,"  "current  conta.i^ions,"  etc.  —  in 
other  words,  that  they  arc  born  to  have  measles, 
whooi)in,n:-eou^d,,  ijcrhaps  ev  n  scarlet  fever,  just  as 
they  arc  born  to  cut  their  tc<  ;h,  if  tliev  live. 

\ow,  do  tell   us,  why  nuist    a  child   have  measles? 
Oh,  because.  >■<  .u  say.  wc  cannot  keep  it  from  infec- 
tion: otiier  children   ha\-c   measles,  an<l  it   must  take 
them,  and  it  is  safer  that  it  shnuld. 

But  why  must  other  children  have  measles?     And 
if  they  have,  why  must  yours  have  them  too? 

If  you  believed  in  an<l  o.bservcd  the  laws  for  j. re- 
serving' the  health  of  houses,  v.hich  inculcate  cK  an- 
li'irss,  ventilation,  whitewasliing,  and  other  means, 
..•:  1  which,  by  the  way,  arc  laivs,  as  implicitly  as  you 
believe  in  the  poy)u!ar  opinion  — for  it  is  nothin.i^  niorc 
than  an  opinion— that  your  child  must  have  child- 
ren's epidemics,  don't  y(.)U  thmk  that  ui)on  the  whole 
your  child  would  be  more  likely  to  escape  alto-,,,],^,,.? 
All  the  results  of  jr(„,(l  nursin.s:,  as  detailed  in  these 
notes,  may  be  spoiled  or  uitcrly  nc-atived  by  one 
iletect,  viz.,  in  pettv  management,  o--  in  (ither  words, 
by  not  knowin.i;  how  to  mana.t^'c  that  wh.it  \  ou  do 
when  you  are  there  shall  lie  done  v,  hen  von  are  n<it 
thiTc.  The  most  devoted  t'ricnd  or  nur-j  cannot  be 
always //avt'.  Xor  is  it  desirable  that  she  should. 
It  is  as  impossiblr  in  a  book  to  teach  a  [lerson  in  char<?e 
of  sick  how  to  ))uiih:i;c  as  it  is  to  teach  her  how  to 
nurse.  Circumstances  must  vary  with  eaidi  .lifTerent 
case.  Hut  it  is  possible  to  press  upon  her  to  think 
fur  herself.   ...  To  be  "in  char-e"  is  eertainlv  not 


2l6 


A  liistor)-  of  Xursini 


on]}-  If)  -irry  nut  tlic  projior  measures  VDUrself  l)ut 
to  see  tr'-.t  every  one  else  docs  so  too:  to  see  that  no 
one,  eitlier  wilfully  or  i,<;norantly,  thwarts  or  iircvents 
surh  measures.  It  is  neither  to  do  cvcrythinfj  your- 
self nor  to  appoint  a  number  of  pcoj,le  to  eaeh  duf  , 
but  to  ensure  that  each  does  that  duty  t(j  whieh  he  is 
ajjpointed.  This  is  t!ic  mcaninj^  whieh  must  be  at- 
taehcd  to  the  word  by  ("above  all)  those  "in  charge" 
of  sick,  whether  of  numbers  or  of  iii'li\i(lua!s. 

Xevcr  to  allow  a  i)aticnt  to  be  waked,  intentionally 
or  accidentally,  is  a  shw  qnj  non  of  all  j^^ood  nursinji. 
If  he  is  roused  ejut  of  his  first  sleej),  he  is  almost  certain 
to  have  no  tiKjre  slccf).  It  is  a  cin-ious  but  cjuite  inti  1- 
lipible  fact  that,  if  a  patient  is  waked  after  a  few  hour>' 
instead  of  a  few  minutes'  slecep,  lie  is  much  more 
likely  to  sleep  a;.(ain. 

l'nnec(-«ary  n<.ise,  then,  is  th(-  most  cruel  absence 
of  care  which  can  be  inllieted  either  on  siek  or  well. 
For,  in  all  these  remarks,  the  siek  arc  mentioned  as 
sufTerin,L:  in  a  <,-reater  [iroportion  than  tlie  well  from 
precisely  ihc  same  causes. 

All  hurry  or  bustle  is  peculiarly  painful  to  the  sick. 
And  when  a  jiatient  has  compulsory  occupations  to 
cnj,'aj,'e  him,  instead  of  ha\in.i:^  simply  to  amuse  him- 
self. It  becomes  doubly  injurious.  The  friend  wlm 
remains  standin^j  and  tiilKcting  about  while  a  patient 
is  talking  business  to  him,  or  the  one  who  sits  and 
poses,  the  one  from  an  idea  of  not  U'tting  the  i)atient 
talk,  the  other  from  an  idea  of  atnusing  him.,  each  is 
equally  inconsiderate.  Always  sit  down  when  a  siek 
person  is  talking  business  to  you,  show  no  signs  of 


Miss  Nin^htin<;-alc's  W'ritini^s 


hurry,  j^ive  complete  attention,  and  full  cnnsidoration. 
if  your  advice  is  wanted,  and  i^i>  away  the  moment  tlu' 
subject  is  cndeil. 

Always  sit  within  the  patient's  view,  so  that  when 
ynu  speak  to  him  he  has  not  painfully  to  turn  his 
head  nnmd  in  order  to  1.  ok  at  you.  Evryl.ody  jn 
voluntarily  looks  at  the  person  speakinj:j.  If  you  make 
this  act  a  wearisome  one  <m  the  part  of  the  patient  vou 
arc  doinr^  him  harm.  So  also  if  by  continuinj^'  to 
stand  you  make  him  continuously  raise  his  eyes  to  see 
you.  Be  as  motionless  as  possible,  and  never  <,'estic- 
ulatcin  spcakinj^to  thesick.   .   . 

These  things  are  not  fancy.  If  we  consider  that, 
-vith  sick  as  with  well,  e\-ery  thouj^'ht  decomposes  some 
nervous  matter,  that  decomposition  as  well  as  re- 
i 'imposition  of  nervous  matter  is  always  ;.;<,in<r  on, 
and  more  quickly  with  the  sick  than  with  the  wcll;--^ 
that  to  obtrude  abruptly  another  th..u,Lrlit  upon  the 
l':ain  while  it  is  in  the  act  of  destroyin^r  nervous  matter 
bv  thinkinj,^  is  calling  upon  it  to  make  a  new  e.\er- 
ti'.n,— if  we  cr.nsider  these  things,  which  are  facts, 
not  fancies,  we  shall  remember  that  W(-  are  doing  pos- 
itive injury  by  interrupting,  by  "startling  a  fanciful" 
person,  as  it  is  called.     Alas!     It  is  no  fancy.   ..   . 

One  hint  I  would  give  to  all  who  attend  or  visit  the 
sick,  to  all  who  have  to  pron.aince  an  opinion  npnn 
sickness,  or  its  progre.s.s.  Come  back  and  look  at  your 
patient  after  he  has  had  an  hour's  animated  conversa- 
tion with  you.  It  is  the  best  test  of  his  real  state  we 
know.  Hut  never  pronounce  upon  him  from  merely 
seeing  what  he  dues,  ur  h<nv  hr  looks  during  such  a 
conversation.   .   .   . 

Irresolution  is  what  all  patients  m.-st  dread.  Rather 
tiianmeet  this  in  ..thers,  they  will  collect  all  their  data 


n 


2lS 


A  I  listoiA'  of  Xiirsi 


n 


^5 


and  make  up  tluir  minds  f.ir  t!u  nisrhrs.  A  (.liani^u 
of  mind  in  ( ilhtrs,  wlutluT  it  is  rf,t:ardin.L,'  an  oiK-ratinn, 
(ir  rewriting,'  a  letter,  always  injures  thu  jiaticnt  more 


<■  up  liis  mind  to  tlu 


than  the  bcins:;:  called  uj)on  to  mak 
most  dreailcd  ordiffirult  decision. 

With  n  ,1,'ard  to  tlie  nadim:  al"ud  in  the  sirk-mom 
my  experience  is  that  when  the  su-k  are  tn.,  ill  to  read 
themselves  they  can  seldum  bear  to  be  read  to. 

The  extraordinary  habit  of  reading,'  to  oneself  in  a 
sick-room  and  reailiii.t;  aloud  tw  the  patient  an\-  bits 
which  V,  ill  amuse  him,  or  more  often  liic  reader,  is 
unaccountably  th(<UL,ditless.  'Wdiat  do  vou  tltink  the 
jKitient  is  thinkinif  of  durin,!,'  your  f^aps  of  non-readin^^r 
Do  you  think  that  !;e  amuses  himself  upon  vdiat  you 
have  read  fnr  precisely  the  time  it  pleases  y  a  to  ^o 
on  readint,'  to  yourself,  and  tliat  his  attention  is  ready 
fc,r  somcthincj  else  at  ])recisely  the  time  it  pleases  you 
to  bc.t:in  reading' a_i.:ain  '  .   .   . 

.  .  .  Volumes  are  nnw  written  and  sjiokcn  u]">n 
tlie  effect  of  the  i^iind  en  the  bnd\-.  Much  of  it  is 
true.  But  I  wish  a  little  nv'Vc  was  thought  of  the 
ctTect  of  the  liody  on  the  mind.   .    .   . 

...  I  think  it  is  a  \'ery  comnvm  error  amons;  the 
v.ell  to  tiiink  that  "with  a  little  more  sclf-coii- 
tr  1  ti'iC  .>n-i<  iri;L;ht,  it  tliev  chiisc,  "distinss  ''aitit'i! 
thou.^hts."  which  " a,i,'.u'ravate  their  di>tase,"  etc.  Be- 
he\e  me,  almost  any  sick  person,  who  behax'es  de- 
cently well,  exercises  mt.re  I'lf-cnntrMl  everv  nujment 
of  his  da_\-  than  you  will  c\ir  know  till  \-(iu  are  sick 
yourself.  Almnst  every  step  that  crosses  his  ViX'Va 
is  painful  to  l;im:  almost  every  thoui^dit  that  passes 
his  bram  is  pamful  t'l  him;  and  if  he  can  sjieak  with- 
out bein.tj  sava<.,'e.  and  look  witlmut  being  unpleasant, 
he  '.s  exercising  self-control.   .   .  , 


Miss  Xij^HuinL;. lie's  \\'iitini;s        210 


\l-\v  little  tlic  r<  :\]  sufTerini,"^  of  illness  are  knnwn 
I'l-  understudil'  II^w  little  ijnes  aiiv  one  in  ^roml 
health  tane\-  him-  (ir  e\-en  /kv-sclf  i.ito  the  life  nf  a  siek 
jierson ! 

D'l,  }-(iu  who  are  abmit  x\u-  siek,  nr  \isi;  the  siek. 
try  and  j^ivc  tln'iii  pleasure,  renieinher  ti>  tell  them 
V,  iuit  wil!  do  sn.  II,,\v  (,ften  in  such  vi:;its  the  siek 
persdH  has  lu  dn  the  whuje  conversation,  exerting;-  hi.- 
own  ima,iL,'i nation  and  memory,  while  \-ou  w.uld  take 
the  visitor,  absorbed  in  his  own  anxieties,  makin;,'  n'l 
effort  of  memory  or  imagination,  for  the  siek  person! 

.  .  .  "What  (an't  be  cured  must  Ijc  endured"  is 
t!u'  \'ery  wurst  and  nv^st  <!_in,L,'erous  maxim  for  a  nurse 
whicii  e\er  was  :.  Ac.  I'atieiiee  and  resi.L^nati-in  in 
her  are  but  other  wurds  for  carelessness  or  indiffer- 
ence—<'ontomptible  if  in  regard  to  lierself,  culpable 
ii  in  rcgar'l  to  her  sick. 

The  most  inijiortant  jiractical  lesson  that  can  lie 
;ji\en  to  nurses  is  to  teach  them  what  to  observe,  how 
tn  (ibscrve,  w'.at  symj)toms  indicate  improvement, 
what  tht'  rcver;<e,  which  are  of  importance,  which  are 
the  evidence  of  ne;:let't.  and  of  wliat  kind  .  ,f  neglect. 

All  this  is  what  oiight  to  make  jiart.  and  an  es.scn- 
tial  part,  of  the  trairiing  of  e\cry  nurse.  At  prcsen. 
h')W  few  there  are,  either  professional  o-  unorofes- 
sinnal,  Avho  really  know  .it  all  whether  anv  sick  person 
they  may  be  with  is  better  or  worse.  ...  It  is  a 
much  more  difficult  thing  to  speak  the  truth  than  ])eo- 
jile  Commonly  imagine.  There  is  the  want  of  obser- 
vation simple,  and  the  want  of  observation  compound. 
compounded.  t;.at  is.  with  the  imaginative  faculty. 
The  informati(jn  of  the  first  is  simjily  deficti\-e.  That 
"I  the  second  is  much  more  dangerous.  Tlie  first  .gives, 
in  answer   to   a   question  asked  about    a   tiling    that 


220 


.\  History  of  Xursin>^' 


has  been  before  his  t'vcs  jjcrhaps  for  years,  informa- 
tion exeee*lin,t^l_\'  iinpertecl.,  or  sa_\'s  he  docs  not  kniiW. 
He  has  iu\cr  obserxed.  And  jieoph:  sim|)ly  think 
him   stujiid. 

Tlic  second  has  obscr\X'd  just  a  little,  but  inia^^ina- 
lion  immediately  steps  i.:,  and  he  describes  the  whole 
thinj^  from  ima,<,'ination  merely,  bein;;  perfectly  con- 
vinced all  the  while  !:iat  he  has  seen  or  heard  it;  or 
he  will  rrpeat  a  wl"i(.le  i  omersation  as  if  it  were  mfor- 
niution  which  had  bcrii  addressed  to  him:  whereas 
it  is  merely  what  he  ha.^  himself  said  to  stmiebody  else. 
This  is  the  commonest  of  all.  These  people  do  not 
e\'en  observe  that  they  ha\e  )u>l  obserwil,  nor  re- 
member that  they  have  forgt)tten. 

Courts  of  ustici'  seem  to  think  that  anybodv  can 
speak  "the  u  hoK>  truth,  and  nothing,'  but  the  truth," 
if  he  docs  but  intend  it.      It  nouires  main'  faculties 


oombuu'i 


d     ot    ol)s(r\-atior 


aui 


and     memory     to    s])eak 
>av    "nothin'j   but   the 


"the    wholf    trut! 
truth." 

In  dwelhnv:  upon  the  \ital  importani.e  of  Si'iiiid  ob- 
servation, it  must  never  be  lost  siglit  of  what  observa- 
tion is  for.  It  is  not  for  the  sake  of  pilin;.:  up  iniseel- 
lancous  information  or  curious  facts,  but  for  the  sake 
of  saving'  hie  and  increasing'  hcdth  and  comfort. 
The  caution  may  seem  useless,  but  it  is  cjuite  surprising; 
how  many  men  (some  women  do  it  tool  practically 
behave  as  if  the  scientific  end  wire  .le  onl\-  one  in 
view,  or  as  if  the  sick  body  were  bn:  ,i  reservoir  for 
stowinj,'  medicines  into,  and  the  surgical  disease  only 
a  curious  case  the  sufferer  has  made  for  the  attend- 
ant's  special    information.   .  ,  . 

For  it  may  safely  be  said,  not  that  thf^  habit  of 
ready  and  correct  observation  will  bv  itstlf  make  us 


Miss  Xightini^alc's  Writing-s 


221 


■:  .^ful  nurses,  l)ut  that  with'.ul  it  uc  sliall  he  usele^is 
with  al!  nur  <le\'ntion. 

It  seems  a  coninvmly  com-eive'l  i^iea  aiimn;;  men 
and  c.cn  aniMni;  women  themselves  that  it  requires 
nnthiriK  hut  a  disappnintmcnt  in  love,  the  want  nf 
an  object,  a  j:reneral  dispust  or  ineai^aeitv  tor  other 
th:in.c:.s,  to  turn  a  woman  into  a  jjood  nurse. 

This  reminds  one  of  the  parish  where  a  stupiri  <ild 
man  was  set  to  be  a  schoolmaster  because  he  was 
"past  keepinp  the  pips." 

Apply  Lhe  abf)ve  receipt  for  making  a  RO(,d  nurse 
t'.  making  a  pood  servant;  and  the  rccei{)t  will  he 
fnund  to  fail. 

.  .  .  The  everyday  nianapem(-nt  of  a  larpe  ward,  let 
alone  of  a  Imspital,  the  knowing  what  are'the  laws  .,; 
lif"  and  death  for  men,  and  what  the  laws  of 
health  for  wards  (and  wards  are  healthy  or  unhealtliv 
ruiinly  according  to  the  knowledge  or  ignorance  o| 
ti:e  nur.se).  are  n..t  these  matters. ,f  sulfieii'iit  imi)ort- 
an^e  and  difficulty  to  re.pnre  learning  liy  experience 
and  careful  inquiry,  lust  ,is  mtu  li  as  anv  other  art.'  ' 

.\V./(-.s-  on  Xitrsi)!:  jor  tlir  /..iluuinn-  r/,;.v<rc<r  is, 
in  somi'  respcds,  the  iii.ist.  iidteworthv  (<(  the  iv- 
visinns  (if  Xcfs  ou  Xitrsing.  It  incorporates  the 
mast  vital  portions  of  \\w  latter  v..,rk  and  con- 
tains an  insinrinp  ami  ni-st  practical  chapter  on 
"The  H(>alth  of  the  llons(  .■'  with  sjiccial  reference 
to;ind  .Ict.n!  tor  riir  d  cottaKH-.s.^     It  .sounds,  inoiv- 

'  Kxtracts  from  Soteson  Xursutg,  iROo.  Hv  p, nnissinn  of 
l>   Apr'etnn  &  Co.,  .Now  York. 

•The  Rural  Hoiisinj;  ,m.|  Sanitation  Association,  with 
ofhces  at  o  Smithumptnn  St  ,  Ifollvrn,  W.  C,  London,  is 
c.irn-tn?  on  this  work  to-d.iy,  htit  cvon  yrt  conditions  are 
painfully  the  fame  as  when  the  Xotcs  was  wTittcn. 


A  Hislorv  of  Xiirsin'-- 


I  tW'I", 


w  ( ir 


(>\( 


an. 

'I'S, 


■niciU    nlc"a    lor   llir    hrtti 


I'lUsiiiLr   i> 


.ml  r\i)r( 


tier  I  II  (11 


I'"' 


ail' 


h stress 


tad' 


suraU'd  Imnic  niiluslrKS 


(.■niiiiit  Knis  auil   uir  (iisasliTs  oi 
1, 


i\v    iiau'li    sickness,    misorx',    and   death   ave   pro- 


ilu> 
li 


llK 


irescnt   state  of  nian\'  faei'^ries,  u.n-e- 


I  iiises, 
where  )> 


\Vi  1 1 


kdi 


'P 


iml     \vf)rkr<>oins! 


T 


aees 


ir  (hassmakers.  t 


iili)rs,  h't ter-iiress  [n'liuci-; 


'1  iitlier  siniihar  traties  liave  to  work 


M"  their  h\iiij,' 


are  i:i'n(_rall_\'  in  a  worse  condition  than  any  otlier  por- 


li  ins  ( it   I  iiir  w'l  irst   ti  iwtis. 


M; 


n\'   ot    these   plae 


are 


rk  \\(  re  ne\  I  r  eonstnuied  for  sucli  an  "hjeet.     Tliey 


i)a> 


adapted    jj;arrets,    sittini^-rooms. 


rooms.   ireneralU'  o\   an  interior  class  oi   houses 


;f  li 


\< 


attention  is  ;  .iid   to   tlie  eiihi'-   space  or  vintilation 
Tlie  pour  woi'kers  arc  crowdeil  oii  the  flour  to  a  i^Mcater 
extent  th;in  <  ci  urs  with  an\-  other  knul  of  (;\-erermv<l- 
.    In    such    places,    ;ind    under    sucli    cireum- 


mi,'.    . 
stance 


iuirnci 


s    of    constr.uncd 
1  ,ind 


ni'-iiilic  Hilt  nie 


bour.  and  foul  air 


l"»tiiic,  want  ot  exercise, 
Ion;;  and  exh.iiistiv'e  la- 
is  il  w<indcrful  that  a  >,;reat 


in 


;ijority  of  theni  die   easily   of   i  ht  st    disease? 


Knipioycrs  seldom  consider  tlicso  thinf,'S.      Healthful 

workin.i,'  rooms  are  no  |)art  of  ilie  liMud  into  whicli 
they  enter  with  their  workinjj  peojjle.  They  pay 
their  money  .  .  .  and  for  this  wage  the  worker  has  fo 


^ivc  up  work,  health,  and  life. 


Workin.ir  pcopli 


shoulil  n 


•mb 


>er  tliat  health  is  their  onlv  capi 


tal. 


should  come  to  an  understandint;  anion.i,'  themselves 
to  secure  ])urc  air  in  their  places  of  work,  which  is  one 
of  the  principal  a}.:cnts  of  iicaith.  This  uxmlJ  he 
worth  a  "trades-union,"  almost  worth  a  "strike  " 
.  .  .  If   tenants  wuulU   be  so  wise  as  to  refuse  to 


Miss  Xic^htinfTalc's  W'ritiiiL^s 


o  -» 1 


•  uTupy  unhealthily  built  homos,  IniiMers  won!,]  soon 
bebrnupfht  1<i  their  S(>ns('S.    .   . 

Presently,  with  Iut  own  inimitable  ifnny.  she 
thf'iws  this  remark  in  a  Inntiidte: 

This  very  year,  iSdS,  a  heaUh  rc|.Mrt  has  appeared 
ill  .Manchester  uliieh  is  virlually  {n  tliis  cITeet :  Let 
the  town  breed  as  mueh  infectious  disea-^e  as  it  likes; 
j>iit  the  cases  into  bi.u;  infirmaries:  this  is  the  way  to 
cure  Manchester — to  build  hospitals  to  cure  people 
at'ter  they  have  been  killed. 

This  c'lition  also  contains  a  t'ha]»ter  on  "Mind- 
in.-  Baby."  the  sweetest,  bri^due.st,  intimate  and 
.simple  talk'  to  t;irls  im;ij.,MnabIe. 

.\nd  now.  j:ir!s,  I  ha\-e  a  word  for  yo\i.  You  and 
I  luive  all  had  a  ^'reat  deal  t(,  do  in  nhndinj,'  baby, 
l!iout,di  "baby"  was  not  our  own  "babv." 

Tims  .she  be.Ljin.'--,  and  ,y;oe.s  on  to  a  talk  on  the 
healtli  and  care  of  infants  that  is  a  juTt'eet  model 
f)f  impnrtatit  trmiis  aii<l  simjile  st\-!(,'.  Few  are 
the  word.s  o\-er  one  sN'llable,  .and  yet  the  most 
thnrou^'h  scientist  niiidit  willinw;l\-  own  its  .aitlior- 
ship.  The  entire  book  is  sanitary  teaeliim,'  in  its 
ni().stconvincinj;  and  ]  crsuasive  t'orm. 

Of    hcT    Notes    on     //<\s-;>;7,?/5,     {^     h.;is     been    s.,i,] 

that  it  has  "j^rob.abh-  done  ii'.ore  tb.-m  ;in\-  other 
treatise  to  ])romote  sound  \ie\\s  of  liosrnt.d 
economy."* 

This,  as  Well  as  twf)  not.ilile  p.ijHTs  on   Indi.i. 

I  Trnt  hospitah.  Iiy  J     I'ost.r  Jfnkins      Amcr.  Sor.  Sri. 
Jotirii.,  May.  ai.  1874. 


224  A  History  of  Nursing 

^ve^e  first  read  ;it  the  meetings  of  the  English  Xa- 
tional  Association  lor  the  Promotion  of  Social 
Science,  afterwards  being  reprinted  in  book  form, 
and  it  has  Iiccn  said  tliat  they  are  the  most  able 
papers  e\er  presented  to  that  association. 

Miss  Xightingale's  genius  was  early  recognised 
by  Sidnrv   Herbert,   and   utilised,   by  him  in   the 
w<irk  (il   ;irnn-   reorganisation.     Though  now  th(> 
least   known   of  her  ^^ritings.   her  various  mono- 
graphs on  thr  army  h,.  1  in  their  day  an  immen.sc 
inlluence,  and   show   most   strikingly  her  remark- 
able mental  '^rasj)  and  generalship.     This  is  par- 
tieul;irl\-   true  of   her    Xotcs  on   ."[Litters   aljcctiiii^ 
the  lL\dtli,  Efficiency,    dnd   Hospital  AJministra- 
lion   of    the    Hriti>h    Army,   presented   by  recjuest 
to  the  Secret'T}   of  State  for  War.  and  i)ublished 
in  1858.     This  (a  work  of  considerable  size)  takes 
up  the  entire  field  of  army  organisation  from  e\-(Ty 
asjjcct  except  that  which  is  purely  militarw  aiid 
discusses,   lirst.  the  entire  otTicial  corrtsjiondence 
and  the  records  of  the  whole  Crimean  canip;ii'.;n, 
pointing   ■  .ut    in   minutest  detail  every  ilefect  in 
organisation  of  the  commissariat,  the  purveying. 
the   medical    departments,    dieting   .and   cooking, 
transport,  statistics,  regiment. d  .and  general  hos- 
pitals, sanitary  (or  unsanitary)  tonr  lit  ions,  laundrv. 
canteens,   and    conditions    of    the   .soldier's  soci.d 
and  family  relations. 

Every  criticism  is  accompanied  by  a  construct- 
tive  neommendation.  Every  riddling  of  clumsy 
inadequacy  is  followed  by  a  picture  of  a  i)ractical 


Mi,-.s  Xightingalc's  Writings 


2^5 


;,n<l  cfTicient  A\T)rkin-  nu'tliod.  Every  exposure 
o:"  slui)i(]il\-  is  linked  with  a  CMrrtsixnidiiis^r  pi^n 
f"'-  attainin.y;  elear  sanitary  bcneliis. 

Miss  Xi,L;htin.-ale's  brilliant  peree])tion  even  re- 
crnistrueted  the  wlioie  nie(Hea!  hierarcdn  ;  slie  (hs- 
eusses  the  pav  and  i)r(inii*tion  of  nieiiieal  olilcers, 
molical  ed.ucation,  sanitary  oflic-ers  for  hos])itals 
and  encampments;  jjives  actual  and  proposed 
firms  for  medieal  statistics  in  the  armv,  and 
shows  the  imp^.rtance  of  a  scientitic  studv  of  the 
diseases  incident  to  arni\'  life. 

All  that  the  Japanese  ha\-e  recenth'  o  brilliantlv 
iltiiUMistrated  could  he  dom  ,  to  reduce  thv  death 
rate  Irom  jM-ewntilde  causrs  to  a  minimum,  s!ie 
Ikto  an<l  elsewhere  besought  the  English  govern- 
ment to  do. 

It  is  n(^t  denied  that  a  lar>:e  part  of  the  British  force 
1  iTished  from  eauses  not  the  uiKUdidaMe  or  iiecessarv 
results  of  war.  .  .  .  (io,o5_^  men,  or  si.xtv  \kt  cent, 
per  annuin,  perished  in  seven  mcjntiis,  front  disease 
dlonc,  up(jn  an  a\eraj^e  strcntjth  of  28,g;,(;.  This  mor- 
tality exceeds  that  of  tiie  Creat  Plaijur  i  ....  The 
([uestion  arises,  must  what  has  here  occurred  oceur 
asjain? 

X')  tribunal  has  ever  yet  tried  this  question  It 
Iianlly  seems  to  have  occurred  to  tlie  national  niiad. 

.  .  .  Immediately  after  the  troops  went  t  >  the 
Kast,  the  i)ractical  inclficiency  of  the  Army  Mi-di.  .il 
Department  began  to  shew  itself. 

Abstracts  of  corrosptmdencf  follow,  showing' 
failures     to    a<lopt     recommendations    made    in 


2  26  A  History  of  Nursing 

H'lvance  ]>y  a  commission  in  chart,'e  of  tlie  health 
of  the  army. 

It  would,  iniiecii,  bo  (hfiicult  to  frame  a  svstom  df 
administratidii  more  likely  t<>  lose  an  arniv  at  anv 
time  than  this.  IKtc  is  the  t\v6t  downward  step  cf 
our  noble  arm_\  to  destruction. 

Al'Straetsof  records  follow  showini;  the  failure 
to  siiii])ly  ])n)per  rations  to  the  arm\-  iti  the  field, 
absence  ot  wiretahles,  and  apijearanei' of  scurvy. 

Thi^  U're.-it  calamity  is  now  (h\:\vint;  to  its  hei.i^dit, 
.  .  .  Had  half  the  in}.,'enuity  e.xereised  in  sending,' 
out  lime  juii  e  been  expended  in  makinj.:  that  article 
unnecessarwihe  armymij^dit  have  returneil  to  Enj^land 
alive  and  wxW.  From  this  point,  the  corresjKind- 
cncc  seems  t<.)  read  as  if  the  medical  oiiice  was  to  re.iris- 
ter  post-»i  Item  apjiearances,  instead  of  keeping;  the 
jialicnt  in  he;ilth  -  as  if  the  business  of  the  police  was 
to  record  murders  instead  of  jirex-entinj,'  them. 

Tn  onbr  lo  m;ike  this  intelligible,  it  is  necessary  to 
,unc  a  short  summary  of  what  the  army  did  receive  in 
\e,L;ctabKN  and  bl.inkets.    .    .   . 

The  siimm.arics  follow,  all  calamitous  facts. 

.  .  .  For  three  months  this  armv  had  not  had 
the  means  of  ch  .mhncss  (no  soa]i)  either  as  to  then- 
persons  or  elothiii_;:  and  what  the  state  <if  the  men 
was.  on  arriving;  at  Scutari,  let  those  wlio  saw  it 
testify.   .  .  . 

Ab-;raets  (if  Ictlrrs  bclween  Dis.  Smith  and 
iiall  h  ijlow,  sa\'im,'  "syinptom.s  of  .seurvv"  are 
appcannc;  amoi^^;  the  men. 


Miss  Xii^^htiiiL^alc's  Writinos        227 


llic  expression  "symptonis  of  scur\-y  "  seems  f]uite 
r  i  xplicahle,  as  well  as  that  ^f  its  "not  :ia\in,t:  made 
ir.'.ieh  pr()o:rcss. "  The  army  was  dyini:.  and  ■  ■(  -eiir\  y. 
Mirc  than  lialf  t!ic  infantry  was  sick  in  hospital  during 
tiiismontli  rjanuary,  1855).  .  .  .  Yet  there  is  not h" 
in-  in  these  letters  t"  indicate  that  either  Principal 
Meiiical  OtiiccrMr  Director-Genera:  know  that  an  army 
is  dyinp,  or  that,  i'"  it  is,  it  is  any  business  of  theirs. 
January  24,  Dr.  vSmith  objects  to  the  issue  of  un- 
j,Tnund  coffee  (the  troops  had.  forf.air  months,  had 
only  grcoi  coffee  beans  issued  to  them). 

X"w-,  also,  arrived  the  linic  juice  .sn  painslak- 
in.yly  scut,  Dr.  Hall  ha\-iii,y;  rcccixcd  all  the  ii-itui- 
cition.s.  hut  .si.\  weeks  after  its  arrixal  it  lia<l  not 
I'vii  <.,M\en  f>ut.  The  winter  having  passed,  com- 
missions Were  a])])()inted. 

'ine  would  think  that  the  fart,  well  known  hv  this 
lime,  of  an  army  haviii-;  all  hut  perished  would  have 
been  of  it.self  a  sufficient  reason  for  the  severest  ani- 
madversion from  the  hea<l  of  the  army  me<lical  dejiart- 
mont.  i^iit  TIM.  'j'hr  Scbastopol  Commit  tee  is  to 
have  the  doin^js  of  that  department  before  it,  and  Dr. 
Smith  writes  to  his  ])rincipal  med    a!  otTicer : 

1  be.L,'  you  to  supply  me,  and  that  imnu'diatclv  "  - 
with  what?—"  with  everv  kind  of  information  whirl, 
you  may  deem  likely  to  enable  me  to  establish  a  char- 
acter for  it"  (the  department),  "which  the  public 
appears  desirous  to  prove  that  it  docs  not  possess." 
What  hope  for  the  .irmy  after  this,^  He  mipht  as  well 
have  said,  Xever  mind  anything  if  you  only  enable  me 
t    free  the  dcfiartnu'iit  from  blame.   .   . 

Analyses  o(  hsts  of  medical  supplies,  and  light 


228  A  History  oi  Xursi 


IT, 


licts,   etc.,  call 


0(1  "  medical  comforts,"    arc   then 


made  and  compared  \\-ith  the  numbers  of  the   sick, 
showing  L,darin^  insufliciencx-. 

On  Jan.  i,  1S55,  tlie  nuir.iMf  of  patients  who  lia^l 
arrived  in  die  huspitals  of  the  Ijosphorus  durn,!,'  the 
lasl    f ortniLdit   amounting   to    :?Si^.  tollowecl   l)v    i 


1044 


more    in    the    next    six    davs,    t! 


le    supernitcndent    oi 
ler  invariable  custom  of  ascer- 


nurscs,  accordin,Lj  ti 
taininfj  first  vduther  tlie  artich.s  for  whicli  requisition 
was  made  upon  her  1)_\'  mcd  al  otfieers  wire  or  were 
not  in  the  purveyor's  stores,  ni  order  that  no  ostent,.- 
tious  ihspja\'  or  unnecessary  i^sue  ir;i^ni  he  made  h\- 
her,  recei\ed  the  foIlowinL;  I'etuin  -- 

in  brief,  of  ])'ates,  caiidlesti(d<s,  tin  drinkiii'^  cnps 


pans 


tor 


tea,    bolsters,    slippers,     ktiucs,     iorks, 


spoons,   tlannel  shirts,   .socdvs,   and   'lra\vei-.s,   there 


were   ;;i'<7i",  o 


f  bed] 


)ans,  soiih'\  and  of  mi^dit-cap 


a/< 


-et  It  not  lie  sail 


^nm 


A  tut 


It  is  all  past,  let  b 


ines  be  1 


un    war  is  iv  a  pa^t 


e  hy- 

W'v  are  speakiiiL.; 


ir- 


f'T  tlie  future.      Otherwise  it  nia\- be  I'rophos.ed 
that,  exaetly  in   the   proportion   in   whieh   similar  e 
eumstanres  rceur.  will  similar  destruetion  recur.      W' 
shall  do  as  b 
disease.   .   .   . 

.Metho,!s    < 


re  aii'l  lose  a^'ain  liall  an  arm.v  Irom 


sanitarA-    adnii'nistratioii    arc    then 


(lisensseo  tulh' 


d  \ou  treat  vour  Direct'rC 


leiierai 


Ilk 


e  a  seUoo 


Ihnv 


\ou  u  HI  lia\e  a  s( 


hooll 


io\-  for  \Mur  Director-Genera 


le   mis(  luet    |m   (he   publie   ser\-iee  is   pro.luced 


this  wav:    vSeientilie  men  ; 


ire  placed  in  a  [losition  n 


Miss  Xightingalc's  Writings 


229 


urin^  tlicm  to  piw-  advice  whether  tlu'v  be  asked  for 


it  or  n./i. 


L>tlicr 


cuiishienitu'iis  not  kinii^'ii  to  their  dc- 


p.utmctit  are  then  acted  uj)on.     Tli 
ol  dest 
consequence  w\ 


IS  IS  a  certain  way 


rovini/  the  sense  (it   rcsponsibi 


Htv 


The 


11   to  that   there  will  be    no   scientific 
men  in  the  department. 

Rccdnimcr.dations  for  an  ideal  .sanitary  ser\-ice 

co\crin_s^r    cx-crv    detail 


then    I'dlli  i\v,    jiracticalh' 
which  the    Jaj 


)ant  sc 


a\'c    since 


Ih 


en 


ptit    into 


]>ractic( 


As  to  latindr\-  tnaltcrs,  Miss  Xi'ditinualc  states 


that  in  the  II 


irrac 


hos])ilal  the  ntnnher  of  towels 


die(l   l)y  the  jiur\-e_\-or  din"inL,r   Xovciuher,    I)e- 
Januar_\-,    with    from    _'ooo   to    2400 

The  aniia- 


ceniner 


aiiil 


jiatients  in  the  wards,  was  1  ^2  towe! 


Mr.  W'reford  wrote  in 


■ebruar\' 


Tl 


le  neces- 


s:iy   for   a   subsidiary  washing  cstablishnienL  has 
nt  ver  been  niadc  ajjparent  to  nie.  "   .   .   . 

.\s  to  the  lack  of  hos])ital  comforts,  Miss  Xight- 


iiV'.de  sa\'s. 


This  has  lieeii  d 


enied 


will 


)e  denied 


a-ain  ;  a  few  official  records  are  therefore  annexed. 


here: 


)f  the  ntirsing   service    ]\hss    Nightingale   says 


If,  with  a  party  of  female  \-(,!unteers  so  siuhlcnly 
formed,  .  .  .  the  labdurs  of  female  nurses  muld  be 
carrietl  on  for  nearly  two  years  ad\antaj,'eous]v  (as  it 
is  jiresunied)  U)  the  soldier,  and  witlioiit  injurious  dis- 
turbance lo  the  medical  and  nuiitary  departments  of 
hospital  governiiK'iU,  w  must  necessaril\-  be  admitted 
that  the  frmale  nursing,'  eleiiieiU  mav  be  inti-odiux'd 
into  militar\-  hosjiitals  in  future,  concurrentlv  with  a 


'1 


230  A  History  ol"  Xursiii-" 

better  system  of  (inierlies:  tlie  TUiniher  n{  nurses  bein<,' 
reslricte.I  and  the  dulies  better  (k-I'med.  It  must  b-- 
added  that  it  is  ai)S(.lutely  necessary  tliat  llie  hi^'ii 
eliaracter  and  respeelability  nf  the  female  must  be 
maintained,  l„,th  as  fi  lier  personal  and  r.tlieial  con- 
duet;  and  no  motives  of  supposed  utility  should  be 
allowed  to  re-juire  or  lead  her  to  do  that  which  v.-(nild 
lower  her  morally  or  otlicially. 

Miss  Xi.L,dttin<,r;d^,  notes  the  fact,  served  by 
"tiler  nurses  later,  that  discipline  in  military  hos"- 
l)itals  d(.es  not  approach  that  of  civil  institutions. 
Of  sj)ccial  interest  alx),  of  }•  r-  \vritin.<,rs  (  a  the 
arniy,  is  her  "Army  Sanitar;  .Administration  and 
its  Reform  under  the  late  hord  IIerl)ert,"  '  for  in 
this  she  sets  forth  in  ( .•  ier  all  the  (Hffercnt  branches 
of  reform  which  we  knov  (tliou,L;i.  she  does  not 
say  so)  Were  in  reality  the-  utcome  of  her  practical 
and  su.u.L^'cstix-e  report.,  made  to  him  pri\-ately. 
She  says : 

...    In    times   past,   war   has   been    conducted   in 

more  or  less  forget  fulness,  sometimes  -n  total  oblivion, 

ot  the  fact  that  the  soldier  is  a  m<,rtal  man,  subject  to 

all  the  ills  lolhjwinj,^  on  wet  and  cold,  want  of  shelter, 

bad  f(Kjd,  excessive  fati.s>:ue,  bad  water,  intemperate 

habits,    and    loul    air.   .   .   .     And   who   can   tell   how 

much    s\stematic   attempts   made   by   all    nations  to 

diminish  the  h<.rrors  of  that  j.^rcat  curse,  war,  may  nnt 

lead  the  way  to  its  total  disappearance  from  the  earth' 

The  faitlitul  records  of  all  wars  are  rccf>rds  of  prcvent- 

ibk'   suli.  rini;,  disease  and   death.      It   is   needless  to 

'  Rea<l  ,a  tho  Lull. Ion  meeting  of  the  Cont^ra  dc  Hifn/ais- 
aiuc,  June,  iS6j. 


Miss  Night! ngalcs  \Vriling.- 


25' 


illustrate  this  ruth,  for  \vc  all  l-.-Kiw  it.  lUit  it  is  only 
trvii  our  laU'Sl  sorrow  ,  the  Crinicaii  cat^istroj^he,  that 
(latL'S  the  rise  of  arm\'  sanitary  administration  in  this 
cduntry.  .  .  .  No  provision  was  ma'lc  for  the  systematic 
rare  of  the  soldier's  health,  but  only  for  his  sickness. 
...  In  all  our  wars,  our  general  hospitals  have 
been  signal  failures,  fatal  e.\.ami)lcs  of  hov,-  to  kill,  not 
t' I  cure. 

She  calls  Herbert  "hij^hcst  amonj;  tlie  savers  f)f 
jnen."  and  says  of  hint: 

."-idney  Herbert,  .:iltli  ugh  his  p.ission,  his  hcredit- 
arv  occupation  to  which  he  was  b(jrn  and  bred  was 
])i4itics,  yet  ma'!'-  his  administrative  labours  greater, 
set  his  administrative  '  bjccts  higher,  recoiled  from 
none  of  its  dry  fatigue,  and  attained  its  highest 
usefulness. 


He  did  not  sink  in  polities  tli"  ])owers  whi>  h  were 
meant  for  mankind.  .  .  The  first  war  minister  who 
seriously  set  himsi  If  lo  the  task  of  saving  life.  .  .  . 
Let  us  hope  that  the  great  lesson  which  h.-is  been 
taugl  ■  will  have  its  weight  with  those  charged  with 
the  duly    ■'  protecting  the  public  health. 


The  Sa)ii:ary  State  of  the  Army  in  fiiJi,:'  is 
likewise  Avritten  in  Itt  most  i'. .usterly,  Uui'l,  and 
trenchant  style.  Ilei"  coninients  nn  the  details 
"i  the  report,  her  summary  of  the  \vhok-,  and  her 
intlictment  of  the  conditions  and  systems  allowed 
ti  I  e.xist  are  scathing  and  unsparing. 

'  Being   observations    on   the   evidence   containcil    in    the 
■   ■  i-ticil  rcjiort  subnutted  to  her  by  the  Royal  Commission. 


2  7  J 


A  llistorv  of  Xursinu' 


Xati\-("  rastf  projuiiicc  [sin  ni, serves]  appears  in 
ha\e  lu'eii  umkIv  tlie  ex(  ust'  fur  ICiirnpcan  laxiiiess  as 
far  ;»s  reijards  our  sanitary  ami  hi)Si)ital  ne.s^'leets  of  tb.c 
nati\e." 

With  an  uns\ver\-iiiL,'-  hand  shv  ilissccts  the-  tVclile 
aiii]  tutiU'  alt(Mn])ts  i  if  <,'<  iwrnmeiUs  to  reu;ulatr 
\-ice  and  ilrink.  "  ("Minmon-.smsr  is  llu'  sanu-  as 
ninral  sense  in  ihi'Si'  thin,L;s,"  slie  concludes. 

in  her  article  <  >n  \'illai:c  Sanitation  in  India' 
her  inexhanstiMc  hninan  syin])atliies  are  sh' a\;i 
ai^ain  in  ln'r  reference  to  tln'  ancient  customs  of 
the  vanished  Hindoo  ci\-ilisation.  This  catholic 
s>-nipathy  was  the  inainsi)nnL,M)f  Ikt  encrL,^\-. 

Under  the  eM  \i]laL:e  oreanisatien  [slie  said]  llie 
villagers,  wnrkin^ir  unijer  tlieir  head  ina!i,  niana<,'ed.  m 
tlicir  humble  \va>-.  e\  ery  department  <if  business  re- 
quired fur  their  h.eal  wants,  and  it  was  the  dutv  of 
certain  l<iw  caste  \  illa.Lre  ser\-ants  to  remo\-e  dead  ani- 
mals and  p(  rform  other  sanitarv  ^vork.  Rut.  nntor- 
tunati'ly,  in  a  larj^e  i)art  of  India  the  \-iila,i;e  s\-stein 
lias  been  allowed  to  fall  into  deeay.  The  ancient 
patriart'ha!  methods  have  ceased  t<i  be  effectual,  while 
as  yet  little  has  been  done  to  tind  anv  modern  suljsti- 
tutc.     The  results  are  \ery  deplorable. 

She  then  quotes  from  the  rc])ort  nf  a  sanitarv 
commission,  and  sa}-s  she  had  had  the  advanta,i,v 
of  corn's] xiiidiiiL,'-  with  these  commissions  and  with 
educated    Indian   ,L;entlcmen   who  were   interested 

'Rt'ail  Prfni-e  Ib.e  Tropiml  Section  ,  ,f  \hv  iSlli  bitern.ition.il 
Congress  of  Ilyyune  ami  DeiiKiyraiihy.  Huda-Pestli.  Septem- 
ber, \^<).\. 


Miss  \ightinL;alc"s  W'ritini^s 


i:i  this  subject,  addint,'  that  it  was  cli\ir  llic  chit  l" 
i!iiI)r(>vc.'nK'nts  iu'cmIin]  witc  a  (liniinutii  m  of  owi"- 
c'rii\V(hn,^,  tlu'  carr\-in^  a^\■a^'  of  sc'\va;^a',  and  a 
1«  rtt-'i"  water  sii])]>l\-,  and  continues: 

As  re.:,'ur(ls  rcincxal  <if  scwa,i;t'  ami  care  <>{  watcr- 
su|']'ly,  much  may  \)v  dniic  1)_\-  the  A'ilhi.i^crs  theinsihas 
if  ihey  can  l)c  made  t"  uniU-rstaml  the  terriMe  result, 
"f  nedect  and  the  Ijcnefits  of  the  most  simple  remedies. 


a\'c    theretMrt 


d'l' 


to    m\' 


ihieal(il    IiKhaii 


Iritiuls  \'>  instruet  tlicir  jHiMrer  liretlirtn  in  tliese  \-itaI 
fanhs.  And  I  liavc  ^antured  to  suL',i:est  to  tliein  tliat 
luahh  missioiiiMS  niii,,dit  he  sent  anion^  the  \alla,!,'ers, 
iiirii  (and  women  also,  to  r' 'inert  the  rural  motlu-rs, 
\\h'ise  influence  in  tliis  matter  is  lU'eat  and  whose  dear- 
( ^i  interests  arc  at  stake)  well  xcrsed  in  the  principles 
(if  sanitation  and  at  the  same  time  s\"mpathetie  and 


e'^nciliatorv, 


Lectures  and 


]iraetical  demonstration^- 


iiiiu'ht  l.)c  'ji\en  out  in  the  xillaij 


c  sciiooi-rooms. 


Hut 


tlic  lectures  would  only  he  the  first  be',qnnin.t;:  oi  the 
Icjchini:;  a  leeturer  who  h.ad  niade  hiir  self  aeeejitahle 
to  the  ]>e<)ple,  would  ,<:o  aroimd  tli^  '  illa^e  and  show 
the  peojile  how  to  dispose'  of  theii-  refuse:  he  would 
explaiti  to  them  the  danirers  of  depositing  it  in 
their  little  close  courtyards.    .    .   . 

Then  lu;  W(  tild  ^^a  with  them  and  examine  dieir 
water-supply,  and  show  them  certain  simj'lc  precau- 
linns  to  be  oliserved.  .  .  .  The  Hindoo  rcli,L,'ion 
enjoins  so  mueh  ])urity  and  elcanlinrss  that  the  influ- 
ence of  reliijious  teachers  and  of  all  caste  Par.eh.ayats 
(ur  councils)  mitrht  be  usefulh-  apjiealed  to.  With  a 
gentle  and  affectionate  people  like  the  Ifmdoos  mueh 
■:.i;.  be  aeeomjilishedljy  personal  inlluenee.  .  .  .  The 
government    is    jiowerful    .   .    .   but   in    such    delicate 


'■34  A  lIist.or\-  of  XursiiT'- 


Hiaitcrs,  nrfccti;!''  tlu>  hnmc; 


an 


1   ciist'inis  nf  a  \Trv 


c'cnserw'itixc  in'Mplf,  alninsl  u\"vv  !na\'  \>v  dnv.v  In"  per- 
S'inal  inlluenc-c,  oxcrcisfii  with  kind!}-  s\'ni]iathy  and 
respect  fur  l!ic  prejudices  of  others.   .   .   . 


( )n  tlic  same  lines,  and  < iverflowint:  with  ca 


ire 


for,  and  eajj;er  intt'rr>l  in,  the  lionies  of  the  i 

l\ural    1[\  dene."'      She 


was  !:er  paiu'r  nn 

tlu-rein  t"  the  wnnian  heahh  niissinners  who  \vere 


loiXMl  li)r  in  India,  and  I'Xidami.'- 


Let  nMt  Ev.i 


an< 


1    la-   ! 


\-ieti()n  that    nothins. 


t'a 


lelii 
n    1 


nd,  I'spfrialh"  in  the  con- 

>(•   d'lne   \\uhiiut    personal 

[t  is  a  truism 


friendship  with  the  wonun  to  1.^  tau^dit. 

to  sa\'  tliat  the  women  who  teach  ir.  India  must  know 


t'c  h 


irii'uai,'!',  tilt 


liL^i' ais  superstitions  and  customs 


oi  the  women  to  he  tau^dit  in  India.      It  ou^ht  to  be 


a  truism  to  sav  the  same  for  I". 


md.      We  must  not 


talk  to  liirm.  or  at  them,  hut  witji  them. 


What    is    the    existiuL:    niachincrv    of   puhlii 


health  in  what  are  called. 


\\i 


th 


a   j;nm  sarcasm,  our 


nual  sanitary  districts"     Is  health  or  sickness,  life  or 


ill,  th 


e  ,1,'reatcst  niir;ud(   m  the  present  eon 


dit 


ion  o 


f 


thin;,':- 
c\-erv 


omc  o)  lis  the  ereatest  mii'at  h 


i\',  is  th 


we  c 


an  li 


\e 


at    ,i!l   in  the 


.  refloat  CI 
surround 


ini,'s  whii  h  our  iunor.ince  and  ne'.^KTt  create 


Aft 


er  re\-iewini:  ttie  cuiKhltoiis, 


nsLation,  ai 


k: 


il.s  (hrtieulties.  slie  .savs  : 


hese  are  1 1 


a(  I  s  as 


thev   are.      Xuw   let 


us  con- 


sider what  ihev  oirdit  to  |,c 


We   Want    indepciidrnl    nu'diia!    olhci'rs   of   health. 


' I'rcsintfd  at  liic  I'onfcrcncc  <.>f  \\\ 
NovetnhiT.  I  St;  5. 


\V, 


L'ds, 


Miss  Nightinj^alc's  Writings        235 


a;i|)ijinted  by  the  cminty  cimncil,  and  removable  only 
iiv  them— men  trained  for  this  as  a  profession;  we 
want  sanitary  insneciors  with  a  projier  qualification, 
appointed  with  the  niedieal  (jftiecr's  approwU :  we 
want  tiiat  eaeii  medical  oftieer  shoi;ld  be  mlornieii  as 
to  all  approaches  of  dan,i;erous  disease,  and  bound  in 
his  term  to  suppl)-  the  information  for  other  nei.i^di- 
bourin^'  districts;  we  want  sanitary  inspectors  whc;  are 
dulv  (lualifiiMi  by  examination  actin.i,'  umler  the  direc- 
tions of  medical  otlicers,  in  order  that  th.ev  may  ft  el 
tiieinselves  responsible  i  >r  their  ;  ppointim^nt,  and 
co-operators  in  tlicir  wwrk,  sanitary  inspectors  who 
are  not  remo\able  unless  for  !ie,i:lcct  of  duty,  and  t-er- 
tain  to  be  remo\-ed  if  they  do  jiersistentlv  ne.Ljleet  it 
We  wai  a  fully  trained  nurse  fc'r  e\er\-  district,  and 
a  health  missioTier;  we  want  a  water-supplv  to  each 
village,  raii;-water  jM-operly  stored;  earth  ijnsets; 
scavenj,;inj^'  as  necessary  a  jmblic  dut\-  as  paxinj,'  and 
lij,'litinj,r  ^-ardens  near  houses,  and  allntnients  where 
refuse  and  \'V\\y  contents  are  used;  .  .  .  cottaj:c 
owners  made  amen,;ble  to  sanitarv  laws,  compellin,^' 
the  landlord  to  ene  his  cottages  the  essentials  for 
health  so  far  as  construction  is  concerned;  schoc)] 
teaching  of  health  rules  made  intcrestinj,'  and  clear  bv 
<lia},Tams  sliowini^  dan;^ers  of  foul  drains,  etc.  (Hut 
we  must  not  exi)ect  too  nmeh  jiractieal  result  from 
this.  It  has  failed,  except  as  a  book  or  lesson,  wheie 
it  has  been  tried  in  India.  The  schoolmaster  himself 
should  be  a  health  aiiostle.  < 

Alter  describing,'  in  dct;iil  tl-.e  absctice  of  a  ^'ood 
sanitary  condition  in.  \"ill.ii;cs  she  scort'lics  and 
n.'iys  piihlic  ;i|Kitti>-: 

In    these    da\s   of     investit,'ations     and     statistics. 


A  History  of  Xur^^ing 


wliere  results  arc  ik-scribcl  witli  nucroscopic  exactness 


and  labulatt 
to  tliink  tiL'u 


itli  mathematical  accuracN',  we  seem 


res  wil 


in-~teail  uf  taci^ 


I'Vl 


Illa- 


tion instead  (^f  acti'Hi.  W'v  rcnii'ml)ei"  the  i"'lieeman 
will)  watched  liis  burglar  enter  ihr  liouse,  and  "Aaited 
to  niakr  i|iiiti'  sure  \vhi.'ther  he  was  ^oinsj;  to  conmiit 
ri)bljcr\'  nith  'ciojcncc  ur  ii'it,  liefiTc  ititerferint,'  with 
his  operations.  So  as  we  ri,ad  sucii  an  accoimt  as  this 
we  seem   to  be   wati  Iiuil;,    nut    I'ubbirw   but    murdir 


};oin,i^  en,  and  ti'  be  waitinj;  Icir  the  rates  ot  in<ir 


to  ^'D  nil  beh  ir(  we  intertei'c, 


W 


e  wait  t<i  see  "o' 


tality 
manv 


children  i>la\ini:  ai''iuni!  tlie  li'iVist'S  shall  ix  stricken 
vlnwn.  We  wail  tu  see  whether  the  filth  \y\\l  really 
trickle  into  the  well,  an<i  wluther  the  foul  water  will 


allv 


>isi>n  the  faniih 


ami 


litiw  manv  ^vul  ihe  o 


fit. 


And  then,  when  eU'iuuh  ha\c  'hcd,  we  think  it  time  t^ 
sj'cnd  soine  nmnex'  and  some  tmublc  to  stop  the  mur 
dcrs  ^oin^'  further,  ai 
"masterly   inacti\it- 


nd  \\('  en'i 


r  the  results  ot  our 
leatly  in  tables,  but  we  do 
not  analyse  and  tabulate  the  saddened  lives  of  those 
whoremain,  ami  tlie  dtsulatc  homes  of  our  "sanitary 
districts." 


.V'lw  ht  us  cme  t"  what  the  women  Iia'i  to  di 
with  it  .  e.,  how  r.nicli  the  cottajje  muthers,  if  in- 
structed, I'V  instructeil  women,  tan  reine  1\'  nr  prevent 
these  and  ntlier  fr:j,ditful  c,  ils,'   .... 

Tlicii  f.  .llov,-.  the  best  syllaluis  of  instinctinn  in 
(loiiK'stic  sanilalimi  th:il  li.is  r\-cr  been  ptit  to- 
gether, and  throii;,;])  \^  .dl  thndis  the  s;iintiialised 
luatcTiial  instinct  whii'h   is   hers  in  rare  fuHness. 

Sympathy  wit'i  interest    in   the  poor  so  as  t"  help 


Mi.^.^  Nicrhtinralc's  Writin'^s 


■J/ 


ihcm  ran  i.nly  !«_■  '^'4  liy  Icni;  ami  close  inton'- airsc 
with  each  in  Iior  uwn  Ivmsc  —not  ]>atriinisint,' — "talk- 
incj  d'lwn  "  to  tluni.  not  " jiryin.tr  aluiut."     Sympathy 


,iiich  will 


'o  >w  HI  ni<iL 


It  an( 


witli  rvcrv  visit 


^iiich  v.'ill  tiuliK'  \on  to  show  the  <ottai:e  ini'tlu-r  on 


the 


ot  how  to  ''ivc  air  to  the  1> 


im.  etc. 


\" 


on 


cnuld  not  jxet  throuj^li  the  daily  work  of  tlu'  cotta.Lje 
ni'ither,  the  cookini,',  washing,  clcanin.c;,  mendin.ij, 
makin.c:.  .  .  .  Aii'l  d  m't  tliink  the  t:ain  is  all  on 
their  side.  How  nnu  h  we  learn  frcjiii  the  poor,  how- 
much    from   our  ;)ati(  nts  in  the  hospital,  when  heart 


meets  heart. 


he  critieisni  on  all   this  will  \i 


'  What    an   enormous  time  it  will  take.      \'ou  are  dc- 
scrihin''  a  ])roeess  that  will  not  take  weeks,  but  nionlhs 


afe  is  not  lon<j  enou'di   for  this. 


Our 


ami  years. 

reply   is   that    for   centuries   there    ha\'e   Ixcn    super- 
stitions,  for  lenturies  the  halats  of  dirt    aiid  ne}.jleet 
have  been  steadily  and  jicrsever:  i<,dy  learnt,  an<l  that, 
i:  we  can  transform  liy  a  few  yi'ars'  quiet,  persistent 
rk  the  habits  of  centuries,  the  process  will  not  have 
iieen  slow,    but    ama/iiivK     rapid.      What    is  "slow" 
in  more  sen.ses  than  one  is  the  eternal  leiturin^'  that  is 
;■. 'V  ct  f»LCtcyca  nihil     words  that  .uo  in  one  ear  and  out 
the  oiher.      The  ^nly  word  that  sticks  is  the  word  that 
.'lows  Work      The  wf)rk  that  "pays"  is  the  work  of 
iie  skilful   hand  directed   by    the  t'ool   head  and  in- 
.^pircd  bv    the  lo\in^  heart.     Join  heai '    with   heart, 
and  hand  with  haml.  and  pray  for  the  perfect  gift  of 
ve  to  be  ihesjiint  and  the  life  of  all  your  work. 
Can  there  be  any  hi.i,'hcr  work  than  this?     Can  any 
'inan   wish  f'lr  a   more  womanly   work?     Can  any 
.III  think  it  unwortlp-  for  the  best  of  women? 


W 


I.'  ai\'  iiiclino.l   to  clas.s  with  her  teacliitis^'s  mi 


I 


23 


8 


A  IIistur\  of  Nursiiii, 


In^'^ifne  and  saiiilatimi  hvv  work  on  Ly'r.ii'-ln  Ilns- 
pi:tils,  a  b'lok  nf  some  size,  charat't  istically  dedi- 
eatfiUo  thi' ■■  Shade  (if  Socrau    '  .Mnther." 

The  iiitrofliK'tion  tells  Ivw,  iv.  the  ■.  var  1.S62, 
the  Xiij;htii\t^ale  committee,  with  a  view  of  extend- 
ini;  the  advaiitaijes  1)1  tlv  Vii^ditingalc -sv-hool,  ma^  > 
arrangements  with  the  authorities  of  St  j  ihn's 
House  liv  wliieh  v.ards  were  fitted  ;]"»  in  he  new 
])art  of  the  Kind's  < '  ^llej^e  hospital,  opening;  ou  >i 
the  ^reat  staircns*  Imt  1  losed  in  behind  their  own 
doors,  for  Ihe  reeeption  of  midwifery  patients. 
The  ^\■ards  and  mu'siii^,  were  under  ihe  charge  of 
the  lady  suj)erintL  dent,  and  e\(.'r\-  precaution 
(as  it  was  thoujj;ht)  was  taken  to  •  euri'  the  well- 
beinj,;  of  the  patients.  But  the  record  of  jnierperai 
sepsis  was  so  gra\e,  exeii  though  not  as  l>ad  ;!S  in 
otlu'r  institutions,  th  I  the  XiL^htineale  eomndtteo 
decided  to  .lose  'ij)  tar  wards. 

Miss  .\i,L;litin_i;.ile  then,  thoUL;h  in  ill-hr;dtl), 
i^axT  her  attention  to  making;  a  thorouj,;h  stu'h' 
of  thr  subject  and  the  eoi^iliiioiis  under  \\hich 
maternil\  hos])!tals  wi're  eondueted.  She  found 
strikint;  \'agueness  and  inexactness  in  the  statistics 
01  many  institutions,  as  w(dl  as  in  ihe  jirevalcnt 
medical  theorirs  on  pui'q-).  -al  sepsis.  True,  med- 
ical writers  had  not  been  lacking;  to  declare  its 
communicable   character,'    vet   others,   of  whom 


'  In  iS4^  Ohvo;  Wcniii-il  llolincs  had  read  his  article  "The 
ront.iKinusnos.';  of  I'mTperal  I'cver"  to  the  Mechcal  Society 
and  declartd  that  it  could  he  carried  from  patient  to  patient 
by  jihysician  and  nurse.     In  this  essay  Holmes  quoted  a  lony 


Miss  Nightingale's  Writings      239 


M;ss  Xij^htingale  quotes  Lc  Fort,  held  that  it  could 


iri'M'nate    dc    noiv.     In    her    i 


n\'sti(rati()n.s    Mis> 


.\ii,'htin.o;ale  found  tliat  the  restrictions  laid  down 
as  to  he  admission  of  studeats  to  the  Ivini^-in 
\v,i:-(ls  at  King's  College  liospital  had  l)een  disre- 
;,'arded;  also  that  a  post-inorlem  theatre  had  hren 
erected  almost  under  the  ward 
di 


wmdows. 


Wh 


]h- 


stie  made  no  l 


-•riticism  on  pL'rsons,  she  empliasised 
Iirinci])les     strong!}-,     and     declared    that     those 


pital  authorities  incurred 


,n-a\e  resjxmsiliilit v 


wild  did  not  assure  themst'lves  that  students  ad- 
tted  lo  niaternit_\-  practice  gave  up,  for  the  tmie 


ir.i 


being,  a.l  C(;nnection  with  general  wards  or  ^v'ith 
anatomical  schools. 

She  (  haracterised  existing  hospital  records  and 
ics  as  grote^ajue  (except  that  the 


(ieath-rate  .-tatist 
suhject  was  so  serious),  pointing  out  that  child- 
birth was  not  a  disease  and  should  not  be  cnte 
as  such,  and  that  it  was  esi)ecially  u'.'just  to  ci 


It  as  a    '  miasmatic 


<  lisease 


Sh 


e  concluded 


rei  1 

iss 
bv 


no 


summing  up  the  e\-idencc  and  sho-.\ing  that 
lyingdn  ward  sliould  be  connected  with  a  general 
Imspital   ser\-ice.    jnd    tluii    presented    plans   and 


.sei 


ledul 


es   l(ir  st'oarate   buil 


iliigs  and  a  j)ro])crly 
nrganised  sep;irate  service  with  midwifery  teach- 
in}/  for  Women . 


In  coming  to  thi>  subject  of  tr; 


unim 


and  organ - 


!:  i  of  distinguished  physiciair;  who  li  id  poinii'd  cut  itscon- 
t.iijious  character.  fjoi'iR  '>;i<'l<  '"  1 'r  l"irdcin  <if  Al.crdicn  in 
17')5-  Seethe  writin>,'s  of  Olivir  Wiiidi  11  11, .lines.  llouKliton 
"V  Mifflin,  Bobi.jii,  i8<;i,  \ol.  i.\.,  ji.  iji  etscq. 


240 


A  IIistor\  o!"  Nursing 


isini:  a  mirsin'f  stafl,  in  which  Miss  Xiij;hun>'ale's 


•/(.■nuis  sni;u  >  S'  > 


l)rilliaiill\' 


'Iter  introiluctiDn 


L'liuld  ln'  ]ilann('il  th;iii  lior  own  i'X])i  jsilion  <if  hvr 
stmHfS   and    dliscrwitii  ^ns   ot    nin'sinir   svstc-nis   as 


lhr\-    C'Xl^lC'il    111     IiSOj. 


Th 


IS  si't  (it  (lata  staiiils 


an  a];])rnilix  to  thr  X^^trs'  lUi  ff(\s-piluls,  wlicix',  it 
is  nuK'li  l(j  1  lo  fcarnl,  lew  jxTsons  l'xxt  soc  it, 
thoiit/h  tht'  rail'  ])ithin(.'s.s,  a(.'unu'n,  and  iudi/nici,t 


s!ii  >\\'u  in  its  ha 


Ian 


tail'. 


and 


■  v\ 


t/hin 


(i!  tiu'  (htltT- 
valuc  far  toi 


cut  .s\'sti'ms  '^\yc  it  an  interest  an( 
'^wut  I'l  lie  recdiieiled  with  ()lili\-ion.  In  its  acute 
(il)ser\-atiiin  and  its  crisp,  fresh  coninniits  it  is 
delii^htfullv  characteristic  of  its  author  and  con- 
laiii.s  Si  )nit.'  ( if  h,'r  hk  ist  ])ertincTit  aphorisms. 

At   the  tinu'  it  was  written,  it  i:a\-e  the  nanus 
of  certain   hos])itals  as  e.xaniiiles  of  each  syste 


(k'serilied.      As,   howe\'er,   to-dav,   main'   of  the 


ni 


sc 


ia\"e  alteri  d.   tiieir  .scnemes  o 


nursme. 


ill 


luimcs 


Ki\e 


lieell      omitted 


as   well    as    some   personal 

allusions. 

[It  ma\-.  howe\-er,  he  !iote(l  that,  at  the  ]irescnt 
da\',  there  ma\   -till  he  fdund,  in  It:i!\',  man\'  e\- 


amiiles  ( 


if  cl; 


iSS 


X( 


I  :   tliat   ex, 


iMlTtle: 


(dass 


may  be  found  in  this  countr}-  and  Canada;  that 
'dass  :;  is  illusirated,  ia  this  couiitr\',  li\'  the  ('(^ok 
('ount\' !i' >s])ii,il.  (diica;,;o.  with  the  Illinois  train- 
ing' sel)i"il.  and  ii\'  Helli  \'ue  hos]iital  with  the 
school  atta(.'he(l  to  it:  tint  the  C.ener.il  hospital 
in  \'ieiina,  Austria,  which  was  mentioned  hv  Miss 
,'  as  lielon^in'.i:  in  (d.:ss  4,  still  helonj^s 


leiina, 

It  Uija 


XlLd 

there,  \\ith  unchai\L;ed  system,  and  that  Class  5 


Miss  Xii^htingalc's  Writings       241 

in-lndos   cenain    military  liosnitals,  and    dt'i'iart- 
iiunts  in  Sdiue  hiis|iitals  for  ihv  iiisaiu-.J 


0\     DirKKRHNT      SVSTKMS      OP      ^^)^IMrAL      XfRSIXC,      AS 
KXISl'IXC,      IX     T|{K     VKAK     lS(>2 

In  tlie  itnp'irtam  (jiK'siinn  nf  acciiii;ni'Hiati"n  tdf 
nurses,  sd  much  dcpcncis  u])iin  the  iiifthod  (,f  luirsiiiL; 
ciiMsen  tliat  an  appendix  is  (Icx-oicd  \i,  this. 

The  methods  of  nursing;  tlie  sick  (thcnj  ad'ijitc  1  in 
the  I'ulilir  hospitals  '  >i  V.uvnyi-  nia_\'  ho  distin.L,'uished 
UH'ler  five  classes: 

1.  Where  the  nurses  lielonir  in  a  reh,L;ii>us  oT-<ler. 
and  arc  under  iiicir  nwn  spiritual  head:  the  h<jsi)ilal 
ln-in<,'  administered  h\  a  separate  and  secular  jjovern- 
inL,'  body. 

2.  Where  the  nurses  are  f)f  a  reli.tjiuus  order,  the 
head   of   which    ;idministers  hotli  order  and  hospital. 

"v  Wheie  tiu^  nurses  a-c  .secular  under  their  own 
head:  tlie  hospital  ha\in,i(  its  own  separate  and  secu- 
lar Lfove  nni  nl. 

4.  Where  the  nurses  are  secular,  and  under  the 
same  secular  authority  as  that  I  :  which  the  iiospital 
where  they  nu  se  is  j^overned. 

5.  Wiiere  the  nurses  are  all  men  and  seculars  and 
under  the  same  secular  male  authority  as  tlie  hospital. 

Of  these  systems  of  nursing;    - 

Xo.  I,  where  the  nu  ses  belonj:!;  to  a  reli<,'ious  order, 
and  are  under  their  dwn  sjjiritual  head — the  liosjiital 
heinij  administerc  il  hy  a  separate  and  secular  govern- 
ing; body — is,  on  the  whole,  best  calcu  ated  to  secure 
J^'ood  nursinjj  for  the  sick,  and  the  pcnera!  wclhbeinjj 
of  both  patients  and  nurses.   .   .   .      ]U]-  m  ^'iving  this 

VOL.   II.  — 1(1. 


242 


A  History  of  Nursin 


unqualificrl   opinion   in   favour  of  nursing  by  sistcr- 
hdoiis,  provided  tlic  aciminisiration  be  secular,  I  must 
add  a  caution  a,c;ainst  two  mistakes,  whether  comnnt- 
ted  in  I'"rance  ^r  in  I-^nirland.  in  Roman  Catholic  or  in 
I'rotestant  institutions,  vi::.,  (i)  the  female  head  of  the 
Sisters  must  reside  in  the  institution  nursed  by  them 
and  neither  in  a  "nurses'  home,"  or  "Maison  Mcn\" 
['Aliich   is]   ;;,)/  tlie   lios|iital.   nor  in  a   "home"  where 
(.iher  Works  d  charity,  not  hospital  ones,  are  carried 
on.      If  she  has  oiher  works  of  charity  which  appear 
to  her  more  important,  then  she  had  better  not  under- 
take hosi)ital  ones.      Hospital  nursin^:  is  jealous,  and 
demands  her  whole'  heart.      It  will  not  havx-  a  divided 
alletjiance.      It  will  not  he  too  nuu  !i  of  her  wh.ole  life 
to  j,'athcr  experience  and  learn  to  o()\-ern  such  institu- 
tions.     It  she  lias  seVer;d  hospitals,  as  the  Au.i^ustin- 
ians  of  Paris,   the   female  head  must   li\e   where  the 
novices,  or  probationers,  or  whatever  they  are  called, 
are  trained.      She  must  be  at  once  matron  of  the  hos- 
pital, which  means  of  the  nursmir  of  it,  and  superin- 
tendent of  the  nurses.      It  will  not  do  for  licr  to  head 
the  nurses  or  ])robati' incrs  in   their  "  liome  "  and  to 
leave  the  heading  ui  them  in  the  liosjutal  to  a  matron, 
or  otiier  superior. 

Xo.  2.  The  Sisters  must  not  be  the  heads  of  wards 
merely  in  order  to  use  "m(>ral  inlluence,"  as  tne  inex- 
pi-rienccd  sometimes  fancy  will  In-  sulhcient.  If  a 
lady  has.  in  addition,  tiie  same  knowledge  and  exjic- 
rience  as  an  old-fashioni'd  hospital  hcui  nurse,  which 
indeed  many  nuns,  bui  only  in  sccula!-l\-  i(o\-erned 
hospital-^,  haw.  ,t;o(nl:  slie  i:;  [\:  to  be  Sister  or  head 
nurse;  il  not .  not. 

X'o  ^  V  here  the  nurses  are  secular  under  their  own 
secular  female  head --the  hospital  ha\ini,'  its  own  sep- 


Mi>s  Nightingale's  Wiitings 


^43 


arate  and  secular  j^'Mvrrnnient    -is  unquestioinhh-  the 
svstem  whifh  stvurcs  tlie  best  nursiIl<,^  after  X".  i . 

( )ul  'it  tile  1 1{  lur  systems  of  mirsinjj;,  Xms.  .>,  4.  ami  5, 
in  eaili  nf  which  there  is  hut  niie  sde  authdnty,  al- 
th"Uj^li  in  \o.  2  a  relij^'icius  une,  in  Xds.  4  and  5  a  seeu- 
lar  one,  over  both  nurses  and  adniiinstratii)n,  are 
(ijually  to  be  rleprecated — 

Xos.  4  and  5  b(H'ause  the  nurses,  whether  male  or 
female,  are  under  the  sole  eomtnand  of  tlie  male  hos- 
]iital  authorities:  in  this  ease  the  arranji;ements  as 
to  hours,  |)roj)rielies,  and  sanitary  rules  ^eneralh'. 
Wduld  strike  any  one  as  all  but  cra/cw  Sut'li 
are  the  rules  which  j^'ive  nurses  twentv-four  hours 
"■n  duty"  in  a  ward,  or  wliieh  ]»ut  them  to 
skej)  with  the  sick,  of  which  the  extreme  case  is  ujicre 
a  female  nurse  is  niade  to  sleep  in  a  man's   ward.  etc. 

In  Xo.  2,  on  the  L-()ntrary,  the  nursinjj^  statY,  whether 
Protestant  or  Roman  Catliolic,  whether  its  lu^ads  ])(,• 
male  or  female,  or  both,  is  in  entire  and  sojc  command 
"*'  the  lios]iital:  in  this  case  tiie  arrani^'etnents  are 
},'enerall_\-  ncaily  as  crazy  as  in  -he  former,  alth.ou,L;h 
the  objects  and  results  are  widely  ditYerent.  Such 
are  the  letting;  a  ])aticnt  dii'  of  a  bed-sore  because 
tiic  nurse  n  ay  spread  the  dressii-.i;  for  it  but  r  ust  not 
look  at  it ;  >  ne  leavinj,'  the  wards  at  ni.Ljht,  or  at  times 
when  the  "comiuunity"  assembles,  in  sole  char'.^'e  of 
subordinates. 

bi  Case  Xo.  4  the  nurses  are  destroved  bodilv  and 
n'orally.  but  the  ]iatients  are  Ljenerally,  not  alwa\s, 
better  nv.rse<l. 

In  Case  Xo.  2  tlu^  jiatients  are  not  ahvax^s.  Init  t^en- 
crally  worse  narsed;  the  sick  are  less  cared  for,  while 
the  spiritual  i,'o(.d  nf  tlie  nurses  is  consulted.  But  tlie 
tare  vi  the  sick  is  the  object  of  hospitals. 


-44 


A  Ili^lorv 


ol 


Xursini^^ 


The  idllisidTi.  often  ili^atrreeable,  but  generally  salu- 
tar\-  fur  the  eare  ut  the  siek,  Ijctwet'ii  the  secular 
a'liiiinistratii>n  ami  I  he  luirsinjj;  staff  (whether  this  con- 
sist of  nulls,  ln'.ithers.  lieaei^iiesses,  or  nurses),  as  is  the 
ease  in  tlie  li'isjiitals  •  <i  Lun'lMn  and  Paris.  kee])S  caeli 
belli.i;ereiit  jiarty  to  his  duty,  and  reacts  ])enetieiallv 
on  th"  interest  -  of  the  sitk.  I'l\-en  the  mutual  iinin  ;- 
tinenee.  jUst  as  often  to  be  heard  between  nuns  arid 
doctors  as  between  doctors  and  ntn-ses,  is  far  betli'- 
for  the  niana'^U'inent  <  ''  a  hosintal,  and  any  iH'^dect  ■  i 
the  sick  is  far  less  likely  to  pass  unnoticed,  than  wIk  n 
;  he  aui  horit  \'  is  soJcK"  in\'ested  in  one  of  1  he  two  wa\s 
al)ove  mentioned:  /.  c,  either  \'csled  in  the  secular 
male  authorities  of  tlie  liospital,  or  in  the  spiritual 
head  o!  th>.  nui'sini' t'SUil  ijislinient  by  either  Protestant 
or  Roman  ("athohc  orders.  Take  the  ninis,  brothers. 
deaconesses  out  of  the  parent  institution,  and  set  them 
to  work  in  a  yvv.'A  secular  hosj.iital,  in  daily  contact 
with  the  (often  \rxaiiousi  exigencies  (jf  doctors  ai;d 


.go\  (.'mors.  ;i 


nd  thc\-  will  work  adniir;ili]\' 


aKe 


Case 


heory   diiTers    widely  from   pr 


tice  m  these  thniL;s. 


If  we  wi're  perfect .  nt 


■uln  an 


absolute  hicrarelu'  would  be  the  best  kind  of  I'lA'ern 


ment  tor  a 


11  ins 


;!uti'  ins. 


Hut. 


in  our  imperfect  state 


of  ct)nscicnce  and  enli'ditenment,  i)ubheitv 


an 


d  tl 


collision  result ini 


fr. 


orii  pu 


blitit' 


are  the 


best 


juar 


ians  of  the  intt  rests  of  the  sick. 


patient   is  nun 


■h 


better  cired  for  in  ;in  institution  wliere  there  is  tlie 
peri)etual  rub  between  doctors  and  nurses  or  nuns, 
betw( 
and 


students,    matrons,    </o\ernors,    treasurers. 


ci-ual 


\1S1 


tois,    beiween    s.^ular    and    siuriiual 


n 


autiiorities  (for  this  ajiplies  (juite  as  much  to  Ronia 
Catholic  as  to  i'^otestani  institutions!  than  in  a  lios- 
piial  under  tiie  best  governed  o  der  in  existence  where 


Miss  Xi<';htin'';,ilc's  Writi 


>^' 


n 


L'S 


'45 


the  chief  of  tha'.  ordcT,  Le  it  n\uh-  nr  icinaK',  is  also  sole 
chief  "i  th(j  liDSi'iial. 

Takin.^  the  inii)erfcct  i^oncral  nm  nf  human  things 
— tor  \vc  arc  considering'  men,  and  not  ani^cls-jjulilie 
dliinion  is  a  hi.i^'hcr  averaj^e  standard  than  indi\idual 
opinion.  I'or  many  years  I  ha\-e  hn'n  tr\-in,:^'  to  tind 
liow  thi';  couhl  he,  sini'e  jiuldic  o])inion  is  made  up  of 
indiviihial  o]dnions.  I  tliink  it  is  liecause  A  uiU  he 
niucli  mcjre  rij,'id  in  makinj,'  H  mind  B's  husincss  than 
in  minding  his  own.  I'uhHc  oianioii  is  L^ood  for  this. 
The  remark  is  not  a  hi.<:h-minded  one.  hut  it  is  true. 

Orders,  whether  R(jman  Cathohc  or  Trotesiain. 
unless  ludd  in  check  by  tlie  rude  c  urh  oi'  puhlie  opin- 
inn,  or  hy  tlie  perpetual  ruh  and  (-(jllision  wiih  the  sec- 
lar  authority  of  the  hospi»al,  are  in.  lined  to  make  into 
a  special  object  the  spiritual  (oft(  n  fancied;  },'ood  of 
their  members,  and  not  the  .general  and  real  good  of 
the  inmates  of  tlie  hospital  (for  \- liom,  iu\erthc]ess. 
the  hospital  was  intended,  and  not  fcr  \\(Jiking  out 
the  sah'ation  of  the  order). 

It  is  had  lor  the  acti\itv  of  any  one  to  liave 
always  Ins  own  way.  And  if  it  weri'  onl\-  for 
th.is,  viz.,  that  no  gn^at  sanitar\'  or  administrati\-e 
inijiroveincnts  lunc  vwv  come  "Ut  of  i.rdei-s.  or  out  of 
seculars  wIt )se  authority  is  undi\ided,  it  would  be 
enough  to  condemn  them. 

Xos.  2  and  4.  Where  the  nurses,  religious  or  secu- 
lar, are  governed  by  the  same  authority,  rt'ligious  or 
secular,  which  govirns  the  hospital,  the  distruction  o' 
health  of  the  memlurs  h^th  of  orders  and  si'i  ular  in- 
stitutions often  takes  place  in  a  piriod  of  ab(jut  five 
years.  This  consumption  (jf  liuman  beings  is  the 
worst  policy  in  e\ery  sense.  Its  op.(_.rati\'e  eau.ses  are 
tuider-teeding.  want  nf  proper  sleep,  \\ant  of  the  most 


MICROCOPY    RESOLUTION    TEST    CHART 

mNSI  and  ISO  TEST  CHART  No    ? 


1.0 


I.I 


!:    "    III  2.0 
nil!  1.8 


1.25 


1.4 


1.6 


r^    'M/^GE      Inc 


246 


A  History  of  Xursinsr 


ordinary  sanitary  precaution — t'lc  result  of  austerity 
in  orders,  ut  an  i.Ljnorant  economy  in  secular  institu- 
tions. In  llie  latter,  want  of  the  most  < ordinary  means 
for   [iropriety    and    ir     ali.y  is  often  a   fou-ih    cause. 

Xo.  2.  In  Some  iii'<titutions  nur-ed  bv  brothcr- 
hodds,  abroad.  a,i:i"'d  .\u^;usiinian  nun.  or  i^u^d  hos- 
pital nuse  from  L-ind^n.  would  turn  e\-ervthin,L,'-  out 
of  window  (tiioii^h  the  former  (  ould  not  do  jll  she 
wou  d  wish',  and  be  as  <lisj,'usted  as  we  ar"  with  their 
pestilential  tilth.  I5ut  al  s!  this  has  been  seen  even 
in  those  nursinj^  sLstcrlh>oJs  where  the  salutarv  check- 
of  the  secular  administ  ation  was  not, 

Xo.  .'.  Where  insti'iition  and  sisterhood  alike  are 
under  the  --ame  .authority.  The  following  remark 
applies  exclusively  to  oilers,  and  to  orders  where  nu 
secular  auihoMt\-  is  in  I'lay.  but  much  more  to  Protes- 
tant than  to  Roman  Catholic  orders,  which  latter 
ha\e  better  sense : 

Tliere  is  a  constant  chancfc  of  occuyjation  of  each 
member  ot  the  o  ijer,  tor  the  sake  of  detachinjT  sai<l 
member  f'om  earthly  things.  To-dav  he  or  she  is  in 
ihe  kitchen,  to  morow  in  a  surijical  ward,  next  week 
in  a  medical  ward,  he  week  at  er  in  he  laundrv.  The 
[)erplexcd  mcdiial  attendant,  when  ^ivin^  his  direc- 
tions about  the  i>atients,  sees  a  new  face,  at  least  every 
fortnight,  to  pivc  his  directions  to. 

In  tlie  best  Roman  Catholic  orders,  especially  \vhcrc, 
as  ir  1,  ih.'  secular  authority  comes  into  action,  there 
is  far  more  lat  iide  ;,MVen  to  individual  character,  and 
scope  to  individual  capacity,  than  we  .ire  a!  ;ill  aware 
of.  Each  member  is  much  more  independent  in  his 
or  her  own  occupation  than  is  the  case  under  ;irrani,'C- 
ment  Xo.  2. 

Xos.  2,  4,  and  5.     Where  there  is  f)Ut  one  authority 


Miss  Niglitingalc's  Writings       247 


over  both  hosyiital  and  nurses,  u-hcthcr  that  anihnritv 
be  rcliKi'ius  (ir  sfi'iilar.  'l"lu'  li'llowinj.;  .  jiiiark  iini)lies 
alike  t"  some  institutions,  both  reH,i;ious  an<i  secular, 
to  all  military,  and  to  some  civil,  t(j  Protestant  and 
Roman  Cathi>Hc  cs' ablislmients: 

The  want  of  one  defmi  e  head  in  permanent  charge 
of  each  ward,  nv  set  of  wards,  invarialjly  acts  disa.s- 
trously  for  the  ])atienfs.  There  should  alwavs  be 
some  one  person  in  ai  knowlcd,<,'ed  resjionsiliilitx-  for 
the  nursing,  \vi  h  servants — call  ihem  lay  Sisters  or 
Brothers,  or  assistant  nurses,  or  what  you  will  un- 
der the  head. 

Religious  motives  in  some  orders,  ;i  want  <if  anv 
practical  ysleni  nf  nursin.i:  in  man\'  military  and  some 
ci\il  hospitals,  re])roduce  the  abo\-e  defect,  in  the  most 
varied  forms,  in  institutions  of  the  most  opposite 
character. 

Xo.  4.  Where  nurses  and  institutions  arc  under 
the  same  sci-ul.'ir  auihurity.  The  fnlldwing  remark 
applies  Sf)le!\'    <i  nistitutimis  secu  ,'irl\'  mirsiMl: 

The  i)ractice  <>f  ha\iiv^'  ni:in  and  wife  in  nm  .  Imi-;;c 
iif  a  ward  or  wards  has  in  it  niM'c  e\  i!  than  good  tur  the 
patien  s  I;  is  tuc  tliat  a  wnman  had  better  flirt 
with  her  hu'^band  tlian  with  a  siuden  f)r  patient:  it 
is  true  that  the  ccninion  ]ih  asc  "-ettlin;,'"  (which 
means  marryins,'  in  si 'me  classes)  has  its  significance 
here,  for  some  women  never  are  "settled"  till  they 
are  married.  Hut  it  is  no  less  true  that  the  interest 
of  the  husb.ind  henceforth  cme  •-  before  that  of  the 
patients,  in  hones*  as  in  dishonest  ways.  The  woman 
is  no  longer  at' ached  to  her  ward,  btit  <<  her  husband, 
and  the  patients  are.  more  or  less,  neglected.  This 
is  still  more  cminiMi'K  the  case  in  regimental  hospi- 
tals, where  it  is  a  common  practice  to  choose  married 


248 


A  Histor\-  of  Xursinuf 


hospital  scrf^cants,  as  bcin^jmnrr  "respectable."  and  t^ 
ha\i-  the  wife  t>  live  in  !  he  in.siiital.  -\s  Wel!  mi^ht 
the  liMsiiital  head  nurse  have  her  husband  tn  li\'c  with 
her  in  the  roMinotY  her  ward. 

Xns.  1  (wliere  the  sisters  are  of  a  reli,t(ious  order,  btit 
the  nurses  are  seeulard  ,s  aiid  4  (when-  all  tht  nurses 
arc  secular,  whether  irovernid  Ii\-  a  se])arate  head 
from  th;it  which  i,'o\a'rns  tln'  hMS]iitah  o-  bv  the  same 
hcadi.  The  cardinal  sm  ot  jianl  nu  ses,  of  all  classes, 
(rf  ,tll  nadons  is  taking;  I'etty  bribes  and  niakini,'  pettv 
ad\-antai,'es  '>i  nian\-  different  sorts  and  sizesi  out  of 
the  jiatients.  Im-oiu  ttiis  sin  ;ill  orders,  whether  Ro- 
man Cathoh  or  I'rotcst.ant ,  ari'  excmjit.  but  from 
it  their  sc;'\-ants  arc  b\'  no  m(  ans  I'Xemjif. 

The  ru'  s  ot  hospital  head  mu'-^cs  in  Lonilm.  were 
they  really  rcliL:i<ci^  women,  who  would  neither  take 
any  present  them-.  l\'e'<,  nor  be  ,i:uilt\-  of  an\-  kind  of 
ini]iropriety.  wmild  enable  tluni  to  cxt'rcise  a  far  uiore 
efficient  sur\cilla!ice  o\rr  assistant  mn-ses.  as  to  both 
these  thing's,  than  .an  In-  exercised  bv  Ri  man  Cath- 
olic or  I'nitcstan;  oiilriN  li\ip.'^'  in  cotnimimt}'.  All 
kinds  ill  timvjs  brtween  n\u'scs  and  jiatients  inav  and 
do  l;o  un  in  the  Sisti^rs'  wards,  when  tlie  SisttTs  arc  out 
of  the  \va\-.  A  Iv.spital  head  nurse  is  (or  oui.;ht  to  be) 
always  in  c  >mm.md  '  'f  her  w  ard. 

'/  o  sitin  lip:  Case  i.  There  is  a  higher  avcrar'e  of 
care  of  the  sick  and  a  hi^dier  unive  sal  sense  of  morab 
itv  atnonj,'  hospital  Sisters.  Protestant  .ind  Roman 
Ciiliolic,  provided  the  hosj.it.al  authorit\-  be  a  secular 
one.  Case  2.  There  is  a  lower  average  care  of  the 
sick.  althouj,di  an  e(|ually  hiirh  morditv.  anionp  hos- 
pital nims.  Protestant  and  Roman  Catholic,  if  the 
hospital  .iuthority  be  not  a  secular  one  Case  ; 
There  IS  a  far  greater  averajje  care  of  1  he  sick,  althoujjh 


Miss  Nightingale's  Writings       240 

a  lower  mtjrality.  among  nurses  under  a  secular  female 
head,  ihe  authority  cf  the  hospital  being  a  secular 
and  separate  one,  than  in  Case  2  :  and  there  is  a  scmie- 
what  higher  average  care  of  the  sick  in  Case  4  than 
in  Case  2,  and  no  morality  at  all,  Imt  an  awful  destruc- 
tion of  biith  life  and  siail.  among  nvirses.  where  Imth 
nurses  and  Iiospital  arc  under  the  same  secular  (male) 
authority.  Case  S-  There  is  no  care  of  the  sick  and 
no  morality,  not  even  ilisiipiinc.  in  hospitals  where 
the  nurses  are  men,  and  wlu'ii'  both  nurses  and  hos- 
])ital  are  under  the  same  .secular  imalci  authority. 
This  is  the  worst  state  of  things  of  all.  Case  2  is  {)er- 
haps  the  second  worst'.  I'or.  take  it  wliich  wav  you 
will,  the  idea  of  the  "rehgi'ais  order"  is  al\\a\'s,  more 
or  less,  to  i)rei)are  the  sick  for  death;  of  the  secular, 
10  restore  tlu'm  to  life  And  their  nursing  will  be 
accordingly.  TIhtc  will  be  instances  of  ]ih\'sii.'al  neg- 
lect (though  geiieralh'  unintenti' 'ii;d  (.n  the  part  of 
the  former:  of  moral  ncclci  '  on  tli.it  ol  tlie 
latter.  Unite  the  two,  and  there  will  l)e  le\.'er  of 
either. 

( )f  com^se  to  ;ill  tins  there  a:  c  exceptions.  This 
appcndi.x  is  dcahng  oii'y  with  systems  of  mirsing  as 
vi>i'.  ins. ' 

The  proper  position  of  the  matron  or  he;i(l  of 
the  nurses  h^is  been  dctincd.  by  Miss  Xightingale 
with  insistent  rcilcratioii.  It  is  a  point  site  never 
faiis  to  dwell  on.  and  nftcii  rectu's  lo  m  her  writ- 
ing. In  one  of  her  tir>t  ]i:i]icrs  on  hospital  organ- 
isati(in  .she  savs : 


iroin    Xotis   on    Uospildh.  by    ponnission   of    the   pub- 
hshcrs.  Longmans,  Cirei'ii  \-  <'(>  ,  London. 


2. so 


A  History  of  Nursing- 


"  I-^qual  in  importance  to  the  provision  of  trained 
nurses  is  the  nature  of  th.e  liospital  auth(;ritv  under 
which  these  nurses  arc  to  perform  tlieir  duties.  For, 
unless  an  understanding  is  come  to  on  this  point  the 
very  existence  of  good  nursing  is  an  iin[)ossibiht\-.  In 
(leahng  with  tins  (juestion  I  may  state  at  once  that  to 
turn  an\-  numher  of  tiained  nurses  into  any  workiiousc 
infirmary  to  act  under  the  superintendent  or  the  in- 
structions of  any  workhouse  master  or  matron  or 
medical  oifieer  would  lie  sheer  waste  of  good,  monev. 
This  is  not  matter  of  ojjinion  but  of  fact  and  experi- 
ence. .  .  .  Experienced  adniinistrati^-s  will  scarcely- 
su!)i)ose  that  I  nuan  to  imply  an  independence  or  to 
ask  for  uncontrolled  hospital  authority  for  the  nursing 
start.  .  .  .  Tlie  matron  or  nursing  sujicriniendent 
must  be  lield  responsible  for  her  own  etlhciency  and 
the  e!ficienc\- of  all  her  nurses  and  servants.  .  .  .  All 
that  the  midical  department  or  the  go\-erning  bodv 
has  a  right  to  recpiire  is  that  the  regulation  duties 
shall  l)e  fait hfullv  performed.  .  .  .  .Whither  the  iiuhI- 
ical  ot'fieer  nor  an\-  other  m;de  head  should  e\(^r  have 
the  jiower  to  ])un.sh  .  .  .  his  diiiv  should  end  with 
reporting  the  case  to  the  female  head.   .    .    .• 

Again,  on  tin-;  ]ioint,  she  wTdtc: 

I   ma\    p(>r!iai)s  again   in.im    out    that  the  superin 
tendeiU   should   hers(  If  be  resiionsible  t"  the  consti- 
tuted hos|)ital  authorities  and  that  all  lier  nurses  and 
servants  should,  in  the  performance  of  these  duties, 
be  resj)onsible  to  the  superintendent  onlv. 

'  From  a  paper  on  traininj;  :ind  organising  nurses  for  the 
sick  poor  in  workhouse  infirmaries  in  Airotiiits  and  Papers. 
vol.  l.\   "  Metrnpolit.in  Workliou.'ies  "      iSt,-. 


Miss  Nightingale's  Writings       251 


.\o  good  ever  comes  of  the  constituted  authorities 
placing  themsehcs  in  the  otiice  which  they  have  sanc- 
tioned her  occupyini^. 

Xo  t;(jod  ever  comes  of  any  one  interfering^  between 
the  head  of  the  nursin<,'  estab'.islmient  and  lier  nurses. 
It  is  fatal  to  discipline. 

All  complaints  mi  any  subject  should  be  made  di- 
rectly to  the  suiierintendent ,  and  nut  to  anv  nurse  or 
servant. 

She  shouhl  be  made  resp(jnsible,  ton.  for  her  results, 
and  not   for  her  niLthuds. 

Of  course,  if  she  does  not  exercise  the  authority 
entrusted  to  her  with  judgment  and  discretion,  it  is 
then  the  legitimate  jirox'ince  (if  the  K'^^"<-'rning  body  to 
interfere,  ami  to  rem(i\-e  her. 

It  is  necessary  to  dwell  strongly  on  this  point,  be- 
cause there  has  been  not  unfrcquentlv  a  disposition 
shdwn  to  make  die  nursing  establisb.ment  res[)onsible 
on  the  side  of  di  cipline  tn  the  mediial  ot'ficcr,  c>r  the 
governor  of  a  hos])ital. 

Any  attempt  to  introduce  such  a  s\stcm  would  be 
tncr-ly  t'l  try  anew  and  f,-id  a:iew  in  an  attcmjit  which 
has  frequently  been  madi\  n  disciplinary  matters  a 
woman  only  can  understand  a  woman. 

It  is  the  dutyof  a  meclical  otTicer  to  give  what  orders, 
in  regard  to  the  sick,  he  thinks  fit,  to  the  nurses.  And 
it  IS  unquestionabh-  the  duty  of  the  nurses  to  obcv  or 
see  his  orders  carried  nut. 

Simplicity  of  rules.  ] (lacing  the  nurst's  in  all  matters 
regarding  management  ni  sick  absolatel\-  \mdcr  the 
orders  of  the  medical  men,  and  all  discijilinarv  matters 
absolutely  imder  the  female  superintendent  matron), 
to  whom  the  medical  otfieers  shouM  report  all  cases 
of  neglect,  is  very  important.     At  the  outset  there 


^52 


A  History  of  NursiiT' 


must  be  a  clear  and  rci-i  tiU'iI  ilcfinition  of  the  limits 
(if  these  two  classes  i^i  juristhctinn. 

The  matr(;n  must  be  one  wh.nse  desire  is  that  the 
jTobationers  shah  learn;  a  rarer  tiling'  than  is  usuallv 
supposed. 

But  beside  th.is  thei'i-  is  a  constant,  inotherh".  in- 
tan<.jible  super\'isii>n  and  observation  to  lie  exercised, 
fur  there  are  qualities  which  no  written  tests  and  no 
examination  can  reach.  The  jirobationers  must  realh- 
be  the  mafon's  children:  the  "home"  Sister  must 
I'calh'  be  their  elder  sister. 

A  training'  school  without  a  mother  is  worse  than 
children  without  parents.  And  in  disciplinary  mat- 
ters none  but  a  woman  can  understand  a  woman. 

In  vie^v  of  sonic  in(i<!ern  tcttdencics  these  words 
of  Miss  Xi.L,dilin,Lra!e  are  alsn  of  interest: 

With  rei'ard  to  an  ott-disputed  (juestion  whtther 
it  is  desii'abh'  to  ti'ain  probationers  entirely  in  a  public 
hosjiital  I  shouli  say,  witJMUt  hesitation,  it  is  there 
(>n!y  that  'hey  en;  be  trained;  and  every  well-judtjiii;.; 
superintendent  will  tell  vou  that  thi'  students,  pjov- 
ernors.  stewards,  eti'.  (disa^'reeable  as  the  collisions 
with  them  sometimes  are),  arc  the  most  valuable 
assets  in  tlie  trainiii.LT  of  her  Tiursi  s.  Whether  in  op- 
position or  in  kindness  she  hears  of  all  tluir  short- 
comings throu}.jh  the  secular  bystand  rs  which  she 
would  hear  of  in  no  other  way.  I  lia\e  rarely  known 
a  nurse  worth  tne  bread  shv  ate  Crolu'lie,  Lutheran, 
or  Anf.,'lican  Sister  or  paid — who  had  imt  been  trained 
under  a  hosjii'al  discipline  consistiiu'  piartly    'if   the 


Miss  Nightingale's  Writings 


-oo 


sccularman  authority  of  the  hospital  and  partly  of  her 
own  female  superintendent.  1  don't  kntnv  whicli  is  the 
\V(irst  manaj^ed — the  hospital  which  is  entire!}'  under 
the  secular  men  heads,  or  tlie  hosi)ital  wliii'h  is  entire!}' 
under  the  su])erintendent  of  the  nurses,  wliethcr  rcliL:- 
idus  or  secular,  whether  male  or  female."  ' 

So,  too,  in  principles  of  trainins.^  hens  are  the 
mnst  clear-cvit  definition.s,  ])enetratiii}j;,  complete, 
aiiii  unanswerable.  In  small  domestic  or  local  de- 
tails time  and  varied  conditions  mav  easih'  prux'c 
soiite  oi  her  directions  to  l)e  ont  of  date,  as  wlu  n 
she  insists  that  the  nurse  should  ahvavs  live  in  the 
hos-[)ital  (it  is  to  be  remembered,  thoti(j;h,  here, 
that  Avhat  she  was  contending;  against  was  a  svs- 
te:n  which  allowed  the  nurse  to  be  a  rnarried  wo- 
Tn;;n  li\'ing  at  home  with  her  famih' and  comiiig 
h\  day  (»r  by  night  only  to  the  ward),  nr  when  she 
sa;  s  that  the  Sister  shotild  command  her  ward 
da.  anil  night,  n'lcaning  that  the  head  nurse  must 
ha-'c  her  li\'ing  and  sleejMng  rodin  adjacent  in  ur 
c\''U  ojH'iiing  out  of  the  ward, — but  her  t'thics  and 
])rinciples  are  for  all  time. 

Training;  is  to  teach  not  only  what  ist'>  be  done,  hut 
hi'W  to  do  it.  The  physician  i>r  surj.,aM)n  orders  what 
is  to  be  diine.  Training  is  to  teach  the  nurse  how  to 
do  it  to  his  iirder,  and  to  tcacli  nut  on!v  Imw  to  do 
it,  but  a7;_v  sudi  and  sucli  a  tlnn^  is  done,  anil  nut  such 
and  sucli  aniillier  ;  as  also  to  teach   svmptoins,   and 

'  tjuoted  in  article ;  "  TrainiriR  Schools  ffir  Nurses,"  Jour- 
nal "/  Social  Science  (Tr,tiisactiniis  oi  the  Aniericun  .\ssocia- 
tiunj.by  F.  B.  S.,p.  394,  Sqjttmbcr,  1874. 


-\S4 


A  History  of  Xursing 


what  syniptfnns  indicate  what   of  (hsease  or  change, 
and  the  "reason  why"  of  such  svniptoms. 

Xearly  all  plix'sieians'  orders  are  eonditifinal.      Tell- 
in,;;  the  nurse  what  to  <h,  is  imt  endii^li  and  eannot  he 
enouj,di    to   jierfeet    lur.    what(>\er   her   suirotindings. 
The  trained  power  of  attcndin;,'  to  one's  own  impres- 
sions made  by  one's  own  senses,  so  that  these  should 
tell  the  nurse  how  tht    palii'nt  is,  is  the  .sine  qui':  ucu 
of  bcinj:;  a  nurse  at  all.     The  nurse's  eye  and  ear  must 
be  trained  :    smell  and  toueh  are  her  two  ri^dit  hands    - 
and  her  taste  is  sometimes  as  neeessarv  to  tlie  nurse 
as  her  head.      Observation  may  alwavs  be  improved 
by    traiinn.L,',    will    indeed    seldom    be    found    without 
trainin.i,':  for  otherwise  the  nurse  does  not  know  \\hat 
to  look  for.      Merel\-  lo<,kin,L,^  at  the  si.  k  is  nr.t  ol)ser\- 
inj,'.     To  h'ok  is  not  alw.ays  to  see.      It  needs  a  hi.Lrli 
degree  of  training  to  look    so  that  looking  shall  tell 
the  nurse  aright,  so  that  she  may  teP  the  medieal  offi- 
cer aright  what  has  ha]ipeneil  in  his  absenee— a  higher 
degree  in  med.ical  than  in  surgical  eases,  beeause  the 
wound  mav  tel!  its  own  tale  in   some  respects;  but 
highest   ot  ;ill,  (if  course,  in  children's  cases,  because 
the  child   cannot    tell  its  own   tale:  it   cannot  always 
answer  questions.     A  conscieiuiMus  nurse  is  not  neces- 
sarily an  observing  nurse,  and  lit'  (ir  death  may  lie 
w-ith  the  good  observer.      Without  a  trained   power 
of  observation,  the  nurse  cannot  be  of  anv  use  in  re- 
porting to  the  medical  attendant.     The  best  one  can 
hope  for  is  that  he  will  be  clever  enough  not  to  mind 
her,  as  is  so  often  the  case.     Without  a  trained  power 
of  observation,  neither  can  the-  nurse  obev  intelligentlv 
his  directions.     It  is  most  important  to  observe  the 
symptoms  of  illness;  it  is,  if  jiossible,  more  important 
Still  to  observe  llie  symptoms  of  nursing:  of  what  is 


Miss  Nightingale's  Writings 


■OD 


the  fault  not  of  tlic  illness,  but  of  tlie  nursin.c;.  Ob- 
servation tells  liou'  the  ])atient  is;  retlection  tells  zchat 
is  III  be  (lone.  Trainin,^  and  experience  are,  of  course, 
necessary  to  teach  us,  tdo,  Jiow  to  observe,  'what  to 
observe,  lunc  to  think,  tc/a;/  to  think.  OV)serva- 
tion  tells  us  the  fact,  reflection  the  meaning'  of 
the  fact.  Reflection  needs  trainint,'  as  much  as 
(ibsir\'ation.  To  oljcy  is  to  understand  orders,  and 
t"  understand  orders  is  really  to  obev.  A  nurse  does 
not  know  ho^v  to  do  what  she  is  told  without  sucdi 
" t.'ainint,'"  as  en.diU'S  lier  to  understand  what  she  is 
told,  or  without  such  moral  disci]ilinarv  "  trainin.i,' "  as 
enables  her  to  i^n\-e  her  whole  self  to  obev.  A  woman 
cannot  be  a  LT'iod  and  intelli.i^'cnt  nurse  without  bein^ 
a  j,'ood  and  intelli.irent  woman.  Therefore,  what 
"trainin^r  "  si.unities  in  the  wide  sense,  what  makes 
a  gojd  training  school,  what  moral  and  disciplinary 
"trainint^"  means,  and  how  it  is  to  be  (jbtained,  is  to 
be  clearly  understood. 

Tlie  essentials  of  a  traininij  school  (or,  indeed,  for  a 
nur-e-establisliment  of  any  kind)  mav  be  shortlv  given 
thus: 

(til  That  nurses  should  ]>c  technically  trained  in 
hosjiitals  i'>\i^ajiiscd  jor  llic  purpose. 

(h)  That  they  should  live  in  "homes"  tit  to  form 
their  moral  lives  and  discipline. 

T!ie  untrained  n\irse,  like  other  ])eo].le  c.-illed  quacks, 
easily  falls  into  the  confusion  of  on  aoionnt  oj .  hcaiisc 
ajtcr — the  blunder  of  th.e  "three  crows."  The  nurse 
is  told  by  the  medical  attendant,  "If  such  and  such 
a  elianijo  occur,  or  if  such  or  such  symptoms  appear, 
\'ou  are  to  do  so  anil  so,  or  to  \-ary  m\'  treatmcm  in 
such  and  such  a  manner."  In  no  case  is  the  phvsician 
or   surpeon    always   there.     Th.e    woman  must    have 


m 


256 


iV  llistor)-  of  Nursing 


trained  powers  of  observation  and  reflection,  nr  she 
cannot  obey.  The  i)atient's  life  is  hist  liy  her  blunders, 
or  ■"sequekT"  of  incurable  infirmity  make  after-life  a 

loni,'  disease,  and  penjile  say,  "  The  dortnr  is  to  blame;" 
or,  worse  still,  they  uik  of  it  as  if  (lod  were  t><  blame — 
as  if  it  were  ("od's  will.  God's  will  is  noi  that  we 
should  leave  our  nurses,  in  whose  hands  we  must  leave 
issues  ot  life  or  (U'ath,  \vithot.it  training;  to  fullil  tlio 
responsibilities  of  such  momentous  issues. 

A  nurse  without  training,'  is  like  a  man  who  has 
never  learnt  liis  alphabet,  wlio  has  learnt  experience 
<inly  fr'im  his  own  blunders.  HluiidtTs  in  exeeutini,' 
physicians'  or  surj^a'ons'  orders  uj)on  the  li\-inj^  bodv 
are  hazardous  ihin.Lrs,  and  may  kill  the  patient.  Train- 
ing is  to  enable  the  nurse  to  see  what  she  sees — facts; 
and  to  do  what  she  is  told,  t"  obev  orders  not  only 
from  the  rule  of  thumb,  but  by  having  the  rule 
of  thought,  of  (ih-^ervation,  to  i^'uide  her.  Otherwise 
she  tinds  out  lur  owti  rnistakes  \>v  experience,  ac- 
quired out  iif  death  rather  than  life,  or  does  not  find 
them  at  all. 

.  .  .  Training  is  to  teach  a  nurse  to  kn<iw  all  her 
business,  liiat  is.  to  observe  exactly.  10  understand, 
til  know  exactly.  t(.)  do,  to  tell  ex.aetlv,  in  such  stu- 
jjcndous  issues  as  life  and  death,  health  and  disease. 
Training  is  to  enable  the  nurse  to  act  for  the  best  in 
carrying  out  her  orders,  not  as  a  machine,  but  as  a 
nurse;  nut  like  Cornelius  Agrippa's  broomstick  which 
went  on  carrying  water,  but  like  an  intelligent  and 
responsible  being.  Training  has  to  make  her,  not 
servile,  but  loyal  to  medical  orders  and  authorities. 
True  h'valty  to  orders  cannot  be  witlmut  the  inde- 
I)en<ienl  sense  or  energy  of  responsibilit  v,  which  alone 
secures    real    tiustworthiness.     Training    makes    the 


Miss  Niirhtiiv-al 


c  s 


W  riliniT.-; 


^^/ 


diflerence  in  a  nurse  that  is  made  in  a  student  b^  'r- 
int;  him  prepare  specimens  for  himself  instead  of 
merely  looking,'  at  the  prepared  specimens.  Training 
is  to  teach  the  nurse  ho-w  to  handle  the  ajijencies  within 
our  control  which  restore  health  and  life,  in  strict 
obedience  to  the  physician's  (^r  surgeon's  ->ower  and 
knowledge,  how  to  keep  the  health  mechanism  pre- 
scribed to  her  in  gear.  Training  must  show  her  how 
the  effects  of  Hfc  <>n  nursing  may  be  calculated  with 
nice  precision — such  care  or  carelessness,  such  a  sick 
rate;  such  a  duration  of  case,  such  a  death-rate. 
And  disci  feline  is  the  essence  of  training, 
.  .  .  Dist-ijiline  embraces  nrder.  nu'thod,  and.  as 
we  gain  some  knowledge  of  the  laws  of  nature  (God's 
laws)  we  not  onlv  see  <  -der,  mctli'id,  a  place  for  c^■cry- 
thing.  each  its  own  work,  but  we  find  no  waste  of  ma- 
terial or  force  orsjiacc;  weiind,  too.  no  !uirr\',  and  we 
learn  to  have  patience  w'tli  our  circumstances  and 
ourselves,  and  so,  as  we  go  on  learning,  we  become 
more  content  to  v.-ork  \\  liere  we  are  jdaced,  more  anx- 
ious to  till  our  appointed  work  than  to  see  the  result 
thereof;  and  so  God,  no  doubt,  gives  us  the  required 
patience  and  steadfastness  to  continue  in  our  "blessed 
drudgery, "which  is  the  discipline  he  sees  best  for  most 
of  us."i' 

What  a  Xurse  is  to  Be.  — A  really  good  nurse  must 
needs  be  of  the  highest  class  of  character.  It  needs 
hardly  be  said  that  she  must  be  (:)  chaste,  in  the  .sense 

'if  the  Sermon  an   tlie   Mount    -a  good  nurse   should 


'From   "  The  Training  of  N'urses,"   Quain's  Dktionary  of 
Midicwc,  od.   of    1894.     Hy   jHTmission    of    the    pulflishers, 
Longmans.  Gruon  &  Co..  Lonion. 
Vol.  II  — :  7. 


'■5& 


A  History  of  Nursing; 


be  the  Sermon  on  the  .Mount  herself.      It  shouhl  nat- 
urally seem  impossible  to  the  nnst  luuT.aste  to  ulttr 
even  an  immodest  jest  in  her  iireseme.       Remember 
this  j,'reat  and  dangerous  ].>eculiarit\-  nt  nursinj^,  and 
especially  of  hospital  nursing:,  naiiiely,  that   it   is  the 
only  case,  queens  not  exee],ted,   where   a  woman   is 
really  in  charj^c  of  men.     And  a  really  gocxl,  trained 
ward  "Sister''  can  keep  order  in  a  men's  ward  better 
than  a  military  ward-master  or  ser<,'eant.      (j)    Sober, 
in   spirit   as  well   as  in  drink,  and    temperate    in  all 
things.     (31    'lonest,  not  accejiting  the  trilling  fee  or 
bribe  from  the  patients  or  friends,      (,^i  Truthful,  and 
to  be  able  to  tell  the  truth  imludi.s  atteiuion  and  ob- 
servation,  to   observe  truly;  memory,   to   remember 
truly;  power  of  expression,  to  tell  truly  what  one  .las 
observed  trul;  ,  as  well  as  intention  to  speak  the  truth; 
the    wliole    truth,    and    nr,  hiiig    but    tlie    truth.      (5) 
Trustworthy,  to  carry  out  directions  intelligently  and 
perfectly  un-""n  as  well  as  sceii,  "to  the  Lord"  as  'uc!i 
as  unto   men — no   mere   eye-str\  iee.      (')    Punctual 
to  asecond,  and  orderly  to  a  hair — having  everything 
ready  in  order  before  she  begins  her  dressings  or  her 
work    about    the    patients:  nothing    forgotten.     (7) 
Quiet,  yet  quick:  quick  without  hurry,  gentle  without 
slowness;  discreet  without  self-importance,  no  gossip. 
(8)  Chcerlul,  hopeful,  not  allowing  herself  to  be  dis- 
couraged by  unfavourable  symptoms;  not  given  to 
distress  the  patient  by  anticipations  of  an  unfavour- 
.iMe  result.       (<))  Cleanly  to  the  point  of  exquisitencss 
both  for  the  patient's  sake  and  for  her  own;  neat  and 
ready,     (10)  Thinking  of  her  patient  and  not  of  her- 
self, "tender    over  his  occasions"  or  wants,  cheerful 
and     kindly,     patient,     ingenious    and     fcal.       The 
best  definition   can  be   found,  asalwavs,  in    Shakes- 


Miss  N'i<'htinof;ilc's  \Vrilin<2s       259 


1. 


nurse- Hkc"    is 


poarc,    whore   lie    !-''ys    that     t 

t(i  be — 

"So  kinci.  sofhueous.  d'.li.ucnt, 

Sn  tt  nder  over  his  oceasions,  true, 

vSnfcat.  "   ' 

The   most   rcniarkalilo   sunnnin^  up   o!    all    hor 
prcvioiis   dicta  mi    tra-nini,^  ami  ideals  is  tound  in 
the  paper  wliieli  Miss  Xi;4htini,^ale  eontrilnited  to 
the  Xursing  Secti'in  <A  the  Coni^ress  >  m  Hospitals. 
Dispensaries,    and     XnrsinL;    al    the    time    ^f  the 
World's  i^.ir  in  Cdhea.uo.      In  r(\aiHn;^r  this  pa])er. 
masterh'  in  its  seojie  anil  i^ras]*.  it  seems  as  it  Miss 
Xi<,'htin;4ale  must  ha\-e  foreseen,  in  ]m>])hetic  vi:;- 
inii.  the  rnushrodm  t:rn\vth  cf  the  ipaaekery  which 
had    not    then    (U'vel<>pt-d,    Imt    which    has    since 
grown    lo  nicnacin.u  jtroportions.      Had   >he  then 
read   the  tldwerv  circulars  issued  hy  commercial 
cnter|jrises,  luhttlin-  the  ])ractical  and  the  disci- 
plinary traimni,\  and  lauihn.^  to  the  skies  all  that 
issupcrHcial  and  flimsy,  she  could  not  better  have 
answered   th(  ir   s(.]>histries.      Hut    Ii>-   nne  ot    the 
ironies  of  fate,  and  a  lanii'n^^aMe -me.  she  foresees 
the  wave  of  pinchbeck  nursing  education  as  .some- 
thing linked  with  regulation  and  examination  by 
the  state  or  an  authorised  central  body,  instead  of, 
as  it  actually  is,  the  irreconcilable  enemy  of  state 
protective  legislation,   which   demands   practical 
service  as  the  sitic  q:'('i  von  for  obtaining  its  shield 
and  iTgis. 

c' N'ursing  the  Sick"  Quain's  Dictionary  oj  Medicine, 
.1  f)f  1804  By  {HTniission  of  the  pubhshcrs.  Longmans, 
Green  &  Co.,  London. 


V3 


260 


A  History  of  Xursip' 


Ani]  sn  thrnuL;h')u^  this  impressive  arldre.ss  runs 
'■'"  •■Ii:i";il  to  ihr  mirsrs  of  Aiiitrir.i  not  to  do  thi> 
tliMi-  which  thcv  have  done  and    have  had  to  dd 
in  oi'der  to  streiit^^hen  the  basis  of  sound  hospital 
trainint,^  a.tjainst  the  sappiiiL'  of  teaehin.t,'  hy  corre- 
spoiidi'iK-e  and  li\-  tlir  elimination  (.fall  real  work. 
When   this  paper  was  rrad   before  the  Ameriean 
nurses  none  of  them  could  have  foreseen  that  ten 
years  after  tluw  liad  heard  it  th(>v  would  he  stead- 
fasth-  and  unitedh"  handed  to-riher  a.i^ainst  sham 
m    nursin.t,^   e.lueation.      That,    in     so   doiu-    they 
have  <lone  what    Miss    Xi.-htin-ale   herself  would 
Have  done,  ,ind   have  kept   before  them  her  own 
stan.lard,  taiinot   be  doubted;  that    in    so    doing 
the}    ha\-e  taken  a  road  which  she  believes  to  be 
astray,  the  road  of  state    pi-oteetinn  for    a    fixed 
basis  of  reiiuiremeiit,  h,as  bet'ii  imA'itable,  and   in 
this  necessary  divergence  lies  much  that  is  to  be 
•  leplored,  for  it  has  meant  an  api)arent  disregard 
of  the  ad\iee  of  one  whose  advancing  years  and 
honour  call  for  all  respect  and  consideration. 

I.  A  new  an  and  a  new  science  has  been  created 
since  and  within  the  last  forty  years.  And  with  it  a 
new  profession— so  tliey  say:  we  say.  nilliiif^.  One 
would  think  this  had  been  created  or  discovered  for 
some  new  want  or  loral  want.  Xot  so.  The  want  is 
nearly  as  old  as  the  wurl(h  nearly  as  lari^e  as  the  world, 
as  pressinjr  as  life  or  death,  h  is  that  of  sickness. 
And  the  art  is  that  of  tinrsiiif;  lite  si\k.  Please  mark 
nursing  the  .v/VA-,  iu>t  nurdng  sickness.  We  will  call 
the  ;irt  nursing  proper.     This  is  generally  practised  !>v 


Miss  Nightingale's  Writings        261 

wnmen  under  scientific  heads — physicians  and  sur- 
;,'ei)ns.  Tliis  is  one  of  the  distinctions  between  nursintj 
projier  and  niedicinc  thou.i,'!!  a  very  famous  and  suc- 
cessful pliysician  did  say,  when  asked  iiow  he  trean'il 
pneumonia,  'I  do  not  treat  pneumonia.  I  treat  the 
person  wlio  luis  pneumonia."  This  is  the  reason  why 
nursin<j;  jiroper  can  only  be  tau^dit  by  the  patient's 
bedside,  and  in  the  sick-ni>im  or  ward  Xeither  can 
it  be  taught  by  lectures  or  by  books.  ihou,L;h  these  are 
valualjle  accessories,  if  used  as  such;  otherwise,  what 
is  in  the  book  sta\"s  in  the  bonk. 


II  l'>nt,  sin.'t-  (",,,d  d;d  not  mean  mothers  to  be 
always  accompanied  by  doctors,  there  is  a  want  older 
still  and  larger  still.  And  a  new  science  has  also  been 
created  to  meet  it,  but  )it>t  the  accompanying  art,  as 
far  as  the  households  are  concerned,  families  schouls. 
workshops,  though  it  is  an  art  which  concerns  every 
family  in  the  world,  wdiii  h  can  onlv  be  taught  from 
the  home,  in  the  home. 

This  is  the  art  of  lualth,  whi(  h  every  neither,  girl, 
mistress,  teacher,  chihTs  nurse,  every  woman  ought 
practically  to  learn.  But  she  is  supposed  to  know  it 
all  by  instinct,  like  a  bird.  Call  it  liciltit  uitrsiiifi  or 
i^nicral  UHfsiuij —what  you  please.  Upon  womankind 
the  national  health,  as  far  as  the  householcl  goes,  de- 
I'cnds.  She  must  recognise  the  laws  of  life,  the  laws  of 
liealth,  as  the  nurse  proper  must  recognise  the  laws 
"f  siikness,  the  causes  of  sickness,  the  symptoms  of 
the  disease,  or  the  symptoms,  it  may  be,  not  of  the 
'iisca.<e,  but  of  the  nursing,  bad  or  good. 

It  is  the  want  of  the  art  of  health,  then,  of  the 
cultivation    of    health,    which    has  only    lately   been 


r'1 


262 


A  I  list()i"\'  of  \iii"m'ii<. 


discovered,  and  ,c:rerit  orcMnisati'  ns  lia\-c  hem  made 
to  meet  it,  and  a  whole  literature  ereated.  \\'e  have 
medical  officers  of  health,  immense  sanitarv  works. 
We  have  not  nurses,  "missioners  "  of  health-atdiomc. 

n(i\v  to  Ijrinir  tliese  ,<rreat  medical  officers  to  bear  on 
the  families,  the  homes  and  households,  and  habits  of 
the  people,  rich  as  vel!  as  jioor,  has  not  lieen  dis- 
covered, althouf^di  family  comes  before  Acts  of  Parlia- 
ment. One  would  think  "family"  had  no  health  to  look 
after.  And  woman,  tlic  .threat  mistress  of  familv  life, 
by  whom  e\erybod_\-  is  born,  has  not  been  praelicallv 
instructed  at  all.  Kvcrythin.^  has  come  before  health. 
We  are  not  to  l(H,k  after  health,  l)ut  after  sickness. 
Wfll,  we  are  to  be  con',-inetd  of  otin-  l)(_'fore  we  are 
ccmvineed  uf  rij^hl:  the  disc  i\ery  of  sin  enmes  before 
the  discovery  of  ri.i^hteousness,  we  are  l'i!d  on  the 
highest  authority. 

'rhouL'h  ever\-l"  Illy  );/,'(.'-7  b^'  born,  there  is  probablv 
no  kiiowjrd^e  more  nej,'lected  than  this,  nor  more 
important  tor  the  f^reat  mass  of  women,  viz.,  how  to 
feed,  wash,  and  clothe  the  babv.and  how  to  secure  the 
utmost  ilranliness  for  moiJi'T  and  infant,  .^bdwives 
certainly  neither  practise  nor  teacli  it.  And  I  have 
even  been  informed  that  many  lady  doctors  consider 
that  they  have  "nothing  to  do  with  the  baby,"'  and 
that  they  should  "lose  caste  with  the  men  doctors"  it 
they  attempted  it.  One  would  have  thought  that  the 
ladies  "lost  ca.ste"  with  themselves  for  not  doing 
it,  and  that  it  was  the  very  reason  why  we  wished  for 
the  "lady  doctors,"  for  tluin  to  assume  these  cares 
which  touch  the  very  health  of  everybody  from  the 
be.ginning.  But  I  have  known  the  most  admirable 
exceptions  to  this  most  cruel  rule. 

I  know  of  no  systematic  teaching,  for  the  ordinary 


Miss  \ii;htin;^'alc's  W'ritini^fs        :!63 

midwife  or  ih'.'  nriiinarv  mother,  how  to  keo]'  the  bal)\- 
in  health,  certaiiil\-  the  most  important  function  to 
mak'e  a  healthy  nation.  The  human  habv  is  not  an 
invalid,  but  it  is  the  innst  tenrler  form  of  animal  life. 
This  is  only  oiv.  hut  a  supremely  important  instance 
of  the  want  of  health-nursim:. 


111.  .\s  the  discovery  of  error  cf»mes  before  that 
of  n,<^dit,  both  in  order  and  in  fact,  we  will  take  first 
f(j)  sickness,  nursing  the  sick:  training,' needful ;  (/») 
health,  nursint^  the  well  at  home:  practical  teachinjr 
needful.  We  will  then  refer  (I\'!  to  some  dangers  to 
which  nurses  are  subject,  (V)  benefit  of  combination, 
and  (VI I  our  ho])es  for  the  future. 

What  is  sickness?  Sickness  or  disease  is  natiuTS 
way  of  gettinir  riil  of  the  effects  of  conditions  which 
ha\e  interfered  with  health.  It  is  nature's  attempt 
tocure.  \Vc  have  to  help  her.  Diseases  are,  practi- 
cally speaking,  adjectives,  not  noun  stibstantivcs. 
What  is  health'  Ibahh  is  not  only  to  be  well,  but 
to  he  able  to  use  well  every  power  we  have.  What 
is  nursing?  Both  kinds  of  nursing  are  to  put  us  in 
the  best  possible  conditions  for  nature  to  restore  or  to 
preserve  health,  to  prevent  or  to  cure  disease  or  injurv. 
Upon  nursing  jjroper,  under  scientific  heads,  phvsi- 
cians  or  surgeons  must  depend  partly,  perhaps  mainly, 
whether  nature  succeeds  or  fails  in  her  attempts  to 
cure  by  sickness.  Xursing  proper  is  therefore  to  hel]) 
the  patient  sufTering  from  disease  to  live,  just  as  health 
nursing  is  to  keep  or  put  the  constitution  of  the 
healthy  child  or  human  being  in  such  a  state  as  to 
have  no  disease. 


!« 


264 


A  History  of  Nursing- 


What  is  trainin.i::-'     Trainiiii;  is  to  teach  thic  nurse 
to  Ik'!].  the  patit'iit  to  \ivv.      Xr.rsin.t;  the  sick  is  an  art, 
and  an  art  rc(iuirin,i,'  an  organised,  practical  and  scien- 
tific training,  for  nursing  is  the  skilled  servant  of  med- 
icine, surgery,  and  hygiene.     A  good  nurse  of  twenty 
years  ago  had  not  to  do  the  twentieth  part  of  what 
she  is  requireil  by  her  physician  or  surgeon  to  do  now; 
and  so,  after  the   year's  training,  she   must    be  still 
t-ainiiig  un(K-r  instruction  in  her  first  and  even  second 
\-car's  hospital  service.      The  physician  prescribes  for 
supi»lying  the  vital  force,  but  the  nurse  sujtplies  it. 
Training  is  to  teach  tlie  nurse  how  God  makes  health, 
and  how   llr  niakis  disease.     Training  is  to  teach  a 
nurse  io  know  hvv  business,  that  is.  to  obscr\e  exactly 
in  such  stupendous  issues  as  life  and  death,  health  and 
disease.     Training  has  to  m;ike  her,  not  servile,  but 
loyal  to  medical  orders   and    authorities.      True  loy- 
alty  to   orders  cannot    be   without    the   independent 
sense  or  energy  of  responsibility,  which  alone  secures 
real  trustworthiness.     Training  is  to  teach  the  nurse 
how  to  ii.tndle  the  agencies  within  our  control  which 
restore  health  and  life,  in  strict,  intelligent  obedience 
to  the  5)hysician's  or  surgeon's  j)ower  and  knowledge: 
how  to  keep  the  health  mechanism  i)rcscribed  to  her 
in  gear.     Training  must  show  licr  how  the  effects  on 
life  of  nursing  may  be  calculated  with  nice  preci.sion 
— such  care  or  carelessness,  such  a   sick-ratc:   such  a 
duration  of  case,  .such  a  death-rate. 

What  is  discipline?  Discipline  is  the  essence  of 
moral  training.  The  best  lady  trainer  of  proba- 
tioner nur.ses  I  know  says:  "It  is  education,  instruc- 
tion, training— all  that,  in  fact,  goes  to  the  full 
development  of  our  faculties,  moral,  physical  and 
spiritual,  not  onb-  for  this  life,  but  looking  on  this 


Miss  XiL,rhtin;^alc's  Writings       26- 


life  as  the  trainint:  L'nnmd  tur  the  future  and  hi.trlier 
life.     ..." 

What  makes  a  <^(>ih]  training;  .school  for  nurses? 
The  most  favourable  conditions  for  the  ailniinistration 
of  the  hospital  are; 

First.  A  good  lay  a  hniiiistration  with  a  chief  ex- 
ecuUve  oflficer,  a  civilian  (be  he  called  treasurer  or 
permanent  cliair:  an  of  committee),  with  power 
(k'lei^ated  to  him  by  the  committee,  who  j^hos,  his 
time.  This  is  the  main  thinu.  With  a  consultini^^ 
committee,  mectmLr  rcLnilarly,  of  business  men.  taking 
the  opinions  of  the  medical  otlicers.  The  meilical 
officers  on  the  committee  must  be  only  consult iiil; 
medical  otKcers.  not  e.xecuuvc.  If  the  latter,  t hex- 
have  often  to  judti^c  in  their  own  case,  which  is  fatal. 
Doctors  are  not  necessarily  admmistrators  (the  exec- 
utive'), any  more  than  the  executive  are  neccssarilv 
doctors.  Vest  ihe  charj^e  of  financial  matters  and 
pencral  supervision,  and  the  whole  administration 
of  the  hospital  or  infirmary,  in  the  board  or  committee 
acting  through  the  permanent  cliairman  or  oth^r  of- 
licer  who  is  responsible  to  that  board  or  committee. 

Second.  A  st'-onir  body  of  medical  officers,  vis- 
iting and  resilient,  and  a  medical  school. 

Third.  The  government  of  hospitals,  m  the 
point  of  view  of  the  real  responsibility  for  the  conduct 
and  discipline  of  the  nurses,  being  thrown  upon  the 
matron  (superintendent  of  nurses),  who  is  herself  a 
trained  nurse,  and  the  real  head  of  all  the  female 
staff  of  the  hospital.  Vest  the  who^.  responsibility 
for  nursing,  internal  management,  for  discij)line  and 
training  of  nurses  in  this  one  female  head  of  the 
nursing  stafT,  whatever  called.  She  should  be  herself 
responsible     directly    to    the     constituted     hospital 


266 


A  1  listorv  of  Xursin; 


.'uUhiirili(_'S,  and  all  her  nurses  and  scrwints  siKniM. 
in  the  performance  of  their  duties,  be  r'.'S])«insil)K'  in 
matters  of  conduct  and  discipline  to  her  only.  X'l 
jjjood  ever  comes  of  the  constituted  authorities  ])lacin.i,' 
themselves  in  the  office  which  they  have  sanctioned 
lu'r  occupyiner.  Xo  l'"'  id  ever  comes  of  anv  one  inter- 
ferinj?  Vjetwei  r.  the  head  of  the  nursincf  establishment 
and  her  nurses.  It  is  fatal  to  discipline.  Without 
such  discipline,  the  main  object  of  the  whole  hospital 
orjranisation.  viz.  to  carry  out  effectively  the  orders 
of  the  physicians  and  sur<,'eons  with  refjard  to  the 
treatment  of  the  patients,  will  not  be  attained. 

IIavin<T  then,  as  a  basis,  a  well  organised  hospital, 
\s'e  require  as  furthi-r  conditions: 

(i  I  A  special  ortjanisation  for  the  ptirpose  of  train- 
ing::, that  is,  where  systematic  technical  traininjj  is 
piven  in  the  wards  to  the  probationers;  where  it  is 
the  business  fif  the  ward  "Sisters"  to  train  them,  to 
keep  records  of  their  ])roj:;:ress,  to  take  "stock"  of 
them:  where  the  proi)ationers  are  not  set  ilown  in  the 
wards  to  "pick  u]i"  as  they  can. 

(2)  A  .<:ood  "home"  for  ihe  yirobationers  in  the 
hospital,  where  they  learn  moral  discipline — f(jr  tech- 
nical training  is  only  half  the  battle,  perhaps  less 
than  half;  where  the  probationers  are  steadily 
"mothered"  by  a  "home"  Sister  (class  mistress). 

(3)  Staff  of  training  school,  (a)  A  trained  matron 
over  all,  who  is  not  only  a  housekeeper,  but  distinctly 
the  head  and  superintendent  of  the  nursing,  (b)  A 
"home"  Sister  (assistant  superintendent) — making 
the  "home"  a  real  home  to  the  ])robationers,  giving 
them  classes,  disciplining  their  life,  (c")  Ward  Sisters 
(head  nurses  of  wards)  who  have  been  trained  in  the 
school — to  a  certain  degree  permanent,  that  is,  not 


Miss  Xightingalc's  Writings       267 


constantly  chan;:;inj;.  For  tliey  arc  the  key  to  the 
\vhole  situation,  the  matron  iiifhiencinji  throu.t^h  them 
nurses  (day  ami  ni.uht),  jimbationcrs,  wanlmaids, 
jiatients.  For.  alter  all,  the  hos])ital  is  for  the  pood 
of  the  patients,  not  for  the  j^ood  of  the  nurses.  And 
the  patients  are  not  there  to  teach  probationers  upon. 
I^ailicr,  jirobationers  had  better  not  be  there  at  all 
unless  they  understand  that  they  are  there  for  the 
IiatientG,    and    not    for   themselves. 

There  should  be  an  entente  cordiale  between  matron, 
assistant  matrons,  "home"  Sister,  ;ind  \vhate^•er 
other  female  head  there  is,  with  frrquL-nt  informal 
meetint,'S,  exchanpin^s;  information,  or  liiere  can  be 
nil  unity  in  trainin,i^. 

Xursini.;  ])ro])er  means,  besides  ,iL,n\"in;.f  tlie  mcilieinL'S 
and  stimulants  prescribed,  or  the  surgical  apjihances, 
the  i)roper  use  of  fresh  air  (ventilation  i,  !i.<,dit,  warmth, 
cleanliness,  quiet,  and  the  jiroper  choosin.L:  md  pixin.L; 
of  diet,  all  at  tlie  least  expense  of  vital  jiower  t(j  the 
sick.  And  so  health-at-home  nursinjj;  means  exactly 
the  same  proper  use  of  the  same  natural  elements 
with  as  much  life-giving  j)ower  as  jiossible  to  the 
healthy. 

We  have  awakened,  though  still  far  from  the  mark, 
to  the  need  of  training  or  teaching  for  nursing  jiroper. 
Rut,  while  a  large  part  of  so-called  civilisation  has 
been  advancing  in  direct  opposition  to  the  laws  of 
health,  we  uncivilised  persons,  the  women,  in  whose 
hands  rests  the  health  of  babies,  household  health, 
still  persevere  in  thinking  health  something  that 
grows  of  itself  (as  Topsy  said,  "God  made  me  so  long, 
and  I  grow'd  the  rest  myself"),  while  we  don't  ♦ake 
tile  saine  care  of  human  health  as  we  do  of  that  of 
(lur  plants,  which,  we  know  very  well,  perish  in  the 


268 


A  History  of  Xursin<^^ 


rooms,  (lark  and  close,  to  which  \vc  too  often  contine 
human  beings,  especially  in  their  sleeiiing  rooms  and 
workshops. 

The  life  duraticjn  of  babies  is  the  most  "delicate 
test"  of  health  conditions.  What  is  the  proj.ortion 
of  the  whole  population  n{  cities  or  countr\  which 
dies  before  it  is  live  years  old?  We  have  tons  of 
printed  knowleiljjje  on  the  subject  of  hvLriene  and 
sanitation.  The  causes  of  enormous  child  mortality 
are  perfectly  well  known:  liiey  are  chictiv  want  of 
cleanliness,  want  of  fresh  air,  careless  dieting  and 
clothing,  want  of  whitewashing,  dirty  feather-beds 
and  bedding  -in  one  word,  want  of  household  care  of 
health.  The  remedies  arc  just  as  wi-ll  known,  but 
how  much  of  this  knowledge  has  been  brought  into 
the  homes  and  households  and  habits  of  the  people, 
poor  or  even  rich?  Infection,  germs,  and  the  like 
are  now  held  responsible  as  carriers  of  disease. 
"Mystic  rites,"  such  as  disinfection  and  antiseptics, 
take  the  place  of  sanitary  measures  and  hygiene. 

The  true  criterion  of  ventilation,  for  instance,  is  to 
step  out  of  the  bedroom  or  sick-room  in  the  nvirning 
into  the  open  air.  If  on  returning  to  it  you  feel 
the  least  sensation  of  closeness,  the  ventilation  has 
not  been  enough,  and  that  room  has  been  unfit  for 
cither  sick  or  well  tn  sleep  in.  Here  is  the  natural 
test  provided  for  the  evil. 

The  laws  of  God— the  laws  of  life-  are  always 
conditional,  always  inexorable.  Hut  neither  mothers 
nor  school-mistresses,  nor  nurses  of  children  are  {)rac- 
tically  taught  how  to  work  within  those  laws  which 
G(jd  has  assigned  to  the  relations  of  our  bodies  with 
the  world  in  which  He  has  put  them.  In  other  words, 
we  do  not  study,  we  do  not  j)ractise  the  laws  which 


Miss  Ni<j^htin;^alc's  Writings        260 


make  these  bodies,  into  which  He  has  put  our 
minds,  healthy  or  unhealthy  organs  of  those  minds: 
we  do  not  practise  how  to  give  our  children  healthv 
ex'stences. 

It  would  he  utterlv  unfair  to  lay  all  the  fault  upon 
us  women,  none  ujion  the  buildings,  drains,  water- 
supply.  There  are  nuUions  of  cottages,  more  of 
town  dwellings,  even  oi  the  rich,  where  it  is  utterly 
impossible  to  ha\-o  fresh  air. 

As  for  theworksh.ops,  work-peoi)lc  sh,ould  remember 
health  is  their  f)nly  capital,  and  they  should  come 
to  an  understanding  among  themselves  noi  onlv  to 
have  the  means,  but  to  use  the  means  to  secure  pure 
air  in  their  places  of  work,  v.hich  is  i>ne  <if  the  (irime 
agents  of  health.  This  would  be  worth  a  "trades 
union,"  almost  worth  a  strike. 

And  the  crowded  national  or  bnard  scho(,)l — in  it 
how  many  children's  epidemics  ha\e  tlit-ir  origin'  And 
the  great  sch')ol  d.)rmitories!  Scarlet  fever  and 
measles  would  be  no  more  ascribed  to  "current  con- 
tagion," or  to  "something  being  much  about  this 
year,"  but  to  its  right  cause:  nor  would  "plague  and 
peslilence"  be  said  to  be  "in  Grjd's  hands,"  when,  so 
far  as  we  know,  lie  has  put  them  int"  our  own. 

The  chief  "ei)idemic"  that  reigns  this  vear  is 
''folly."  You  must  form  public  opinion.  The  gen- 
erality of  officials  will  only  do  what  you  make  them. 
Von,  the  public,  must  make  them  do  what  vou  want. 
Rut  while  p/ublic  opinion,  or  the  voice  of  the  people, 
is  somewhat  awake  to  the  building  and  drainage 
question,  it  is  not  at  all  awake  to  teaching  mothers 
and  girls  jiractical  hygiene.  Where,  then,  is  the 
remedy  for  tliis  ignorance? 

Health   in   the   home  can   onlv  be  learnt   from  the 


2  TO 


A  1  lislorv  of  Xiir^in. 


homo  and  in  'licli'ime.  Some  (.'niincnt  meilKal  olTiccrs, 
rcfcrrin,i,'  to  anilailanc,'  lectures,  nursing  lectures,  the 
fasliionalile  hvLrienic  lectures  of  the  day,  have  ex- 
pressed the  ojjinion  that  we  do  no  more  tlian  play 
with  our  subject  when  we  "sprinkle"  lectures  over 
the  community,  as  that  kind  of  teaidiint,'  is  not  in- 
struction, and  can  never  be  education:  that  as 
medicine  and  surt,'ery  can,  like  nursinji;,  only  be 
properly  tauj,dit  and  properly  learnt  in  the  sick-room 
and  by  tlic  })atient's  side,  so  sanitation  can  only  be 
taught  [)ropcrly  and  learned  y)ro])erly  in  the  home 
and  house.  Some  attempts  ha\e  been  made  practi- 
cally to  realise  this,  to  which  subsequent  reference 
will   l:)e  made. 

Wise  men  tell  us  that  it  is  expecting  too  much  to 
suppose  that  we  shall  do  any  real  good  by  giving  a 
course  of  lectures  on  selected  subjects  in  medicine, 
anatonn,  phj'siology,  and  other  sucl\  cognate  suU 
jects,  all  "watered  down"  to  suit  the  public  palate, 
which  is  really  the  sort  of  thing  one  tries  to  do  in  that 
kind  of  lectures. 

[t  is  surely  not  enough  to  say,  "The  people  are 
nuich  interested  in  the  lecture."  The  i)oint  is, 
Did  they  practise  the  lecture  in  their  own  homes 
afterwards?  di.l  they  really  api^ly  themselves  to  the 
household  health  and  the  means  of  improving  it? 
Is  anvthing  better  worth  i)ractising  for  mothers 
than  the  health  of  their  families? 

The  work  we  are  speaking  of  has  nothing  to  do 
with  nvirsing  disease,  but  with  maintaining  health 
by  removing  the  things  which  disturb  it,  which  have 
been  summed  up  in  the  population  in  general  as 
"dirt,  drink,  diet,  dani]),    Iraughts,  drains." 

But,  in  fact,  the  people  do  not  believe  in  sanitation 


Miss  Nightingale's  \\'ritin<^s 


171 


as  i.  lectin^'  health,  as  ])r('\-cntin,i:  disease.  They 
think  it  is  a  "fad"  of  tlie  doctors  and  ricii  pcoydc. 
They  believe  in  eatchinj,'  cold  and  in  infection,  catchinjj; 
complaints  from  each  other,  but  not  from  foul  earth, 
bad  air,  or  impure  water.  May  not  some  remedy  be 
fiiund  for  these  evils  by  diroctin.i,'  the  attention  of  tlie 
].ublic  to  the  trainin<T  of  health-nurses,  as  has  alreadv 
liecn  done  with  re<,'ard  to  the  training  of  sick-nurses? 

The  scheme  before  referred  to  for  health-at-home 
nursinjj  has  arisen  in  connection  with  the  newly-con- 
stituted administration  of  counties  in  En;,'land,  by 
which  the  local  authority  of  the  county  (County 
Council)  has  been  invested  by  Act  of  Parliament 
with  extended  sources  of  income  ajjplicablc  to  the 
Icaihing  of  nursinj^:  and  sanitary  knowledge,  in 
ailition  to  the  powers  wliich  they  already  possessed 
fnr  sanitary  inspection  and  the  prevention  of  infectious 
diseases.  This  scheme  is  framed  for  rur;i!  districts, 
but  the  general  jmnciples  are  also  applicable  to  urban 
pnpulaticms,  though,  where  great  numbers  are  massed 
together,  a  fresh  set  of  difficulties  must  be  met,  and 
different   treatment   be  necessarv. 

The  scheme  contemplates  the  training  of  ladies, 
so-called  health  missioners,  so  as  to  (|ualifv  tlicm  to 
give  instruction  to  village  mothers  in:  (i)  The  sani- 
tary condition  of  the  person,  cloihes  and  bedding,  and 
house.  (2)  The  management  of  health  of  adults, 
women  before  and  after  coniinement,  infants  and 
cliildren.  The  teaching  by  the  health  missioners 
would  be  given  by  lectures  in  the  villages,  followed 
by  personal  instruction  by  way  of  conversation  with 
the  mothers  in  their  own  homes,  and  would  be  di- 
rccteil  to:  (il  The  condi-tion  of  the  homes  them- 
stlves  in  a  sanitary  i)oint  of  view;  (2)   the  es.sential 


272 


A  lIisU)ry  of  Nursini;- 


principles  of  kccjnnc:  the  body  in  health,  with  refer- 
ence to  the  skin,  the  circulatinn,  ami  the  dif^estion; 
and  (3)  instruction  as  to  what  to  do  in  cases  of  emer- 
gency or  accident  before  the  doctor  comes,  and  witii 
reference  to  the  manaLjement  of  infants  and  cliildren. 
In  the  addendum  to  this  paper  will  be  found  a  scheme 
for  training  health-at-home  missioncrs,  a  syllabus  of 
lectures  .ijix'cn  b\-  the  medical  officer  to  the  healtii 
missioners,  and  a  syllabus  of  b.ealth  ]t\'tures  ^n\cn  by 
the  health  missioners  to  villaj^c  mothers. 

IV.  Dangers.  After  only  a  jj^cneration  of  nur.sin},' 
arise  the  dan^'crs:  (x)  Fashion  on  the  one  side,  and 
its  consequent  want  of  earnestness,  (j)  .Mere  money- 
getting  on  the  ther.  Woman  does  not  live  by  wages 
alone.  (3)  Makin,,'  nursing  a  jirofcssion,  and  not  a 
calling. 

What  is  it  to  feel  a  callwg  for  anything?  Is  it  not 
to  do  our  work  in  it  lo  sa.:.->fy  the  high  idea  of  what 
is  the  right,  the  best,  and  not  because  we  shall  be 
found  out  if  we  don't  do  it  ?  This  is  the  "enthusiasm " 
which  every  one.  from  a  shoemaker  to  a  sculptor, 
must  have  in  order  to  follow  his  "calling"  properly. 
Now,  the  nurse  has  to  do  not  with  shoes  or  with 
marble,  but  with  living  human  beings. 

How.  then,  to  keep  up  the  high  tone  of  a  calling,  to 
'■  make  your  calling  and  election  sure  '?  By  fostering 
that  bond  of  sympathy  {esprit  de  corps)  which  com- 
munity of  aims  and  of  action  in  good  work  induces: 
a  common  nursmg  home  in  the  hospital  for  hospital 
nurses  and  for  probationer  nurses;  a  common  home 
for  private  nurses  during  intervals  of  engagements, 
whether  attached  to  a  hospital,  or  separate;  a  home 
for  district  nurses  (wherever  possible),  where  four  or 
five  can  live  together;  all  homes  under  loving,  trained, 


Miss  Nightingale's  Writings      273 


iiicral,  an«l  rc'li,L,auus,  as  well  as  technical  suyicrintcnd- 
cmc,  such  as  tu  keep  up  the  tune  of  the  inmates  with 
eimstant  sujijily  of  all  material  wants  and  constant 
sympathy.  Man  caniiMt  li\c'  hy  l)read  alone,  still  less 
woman.  Waj^es  is  nr.t  the  only  question,  but  high 
homc-hclps. 

The  want  o£  these  is  more  csjiecially  felt  among  pri- 
vate nurses.  The  development  in  recent  years  of 
trained  private  nursing,  i.  c,  of  nursing  one  sick  or 
injured  person  at  a  time  at  home,  is  astonisliing.  But 
not  less  astonishing  the  want  of  knowledge  of  what 
training  is.  and,  indeed,  of  what  woman  is.  The  dan- 
ger is  that  the  jirivate  nurse  may  bec(jme  an  irresponsi- 
ble ntimad.  She  has  no  home.  There  can  be  no 
c^piit  dc  corps  if  the  "corps"  is  an  indistinguishable 
mass  of  hundreds,  perhaps  thousands,  of  women  un- 
kn>v.n  to  her,  except,  perhaps,  by  a  name  in  a  register. 
All  community  of  feeling  and  higher  tone  absents 
iistlt.  And  too  often  the  only  aim  left  is  to  force  up 
wages.  Absence  of  the  nursing  home  is  almost  fatal 
to  keeping  up  to  the  mark,  .\ight  nurses  even  in 
!ios|iitals,  and  oven  district  nurses  (another  branch 
"1  trained  nursing  of  the  sick  poor  without  almsgiving 
which  has  developed  recently),  and  above  all  private 
nurses,  deteriorate  if  they  have  no  esprit  de  corps,  no 
ommon  lumic  under  wise  and  loving  supervision  fur 
intervals  between  engagements.  What  they  can  get 
in  holidays,  in  comf(irts,  in  money,  these  good  women 
<.iy  themselves,  is  an  increasing  danger  to  many.  In 
private  nursing  the  nurse  is  sometimes  spoilt,  some- 
times "put  upon,"  sometimes  both. 

In  the  last  few  years,  private  trained  nursing,  dis- 
trict trained  nursing,  have,  as  has  been  sai(i,  gained 
:""ieasurably  in  imj)ortance,  and  with  it  how  to  train, 

1-    11— IB. 


74 


A  ir.sttirv 


nl 


XurNinir 


how  to  j^'<)\ern  (in  tlic  sense  nf  keeiun.i,'  u]i  to  the  high- 
est attainable  in  tune  ami  eharacter,  as  well  as  in 
tcehnical  training),  must  gain  also  immcasuraMy  in 
inipiirtanee.  must  constitute  almost  a  new  starting- 
I)()int.  Xursing  may  cease  to  be  a  calling  in  any  I  ?t- 
ter  sense  than  millinery  is.  To  have  a  life  oi  freedom, 
with  an  interesting  em])loyment,  for  a  few  years — to 
do  as  little  as  you  can  and  amuse  yourself  as  much  as 
you  can  — is  |K)ssibly  a  danger  pressing  on. 

(4>  There  is  another  danger,  perhaps  the  greatest 
of  all.  It  is  also  a  danger  which  grows  day  by  dav. 
It  is  this;  as  literary  education  and  colleges  for  womc  n 
to  teach  literary  work  start  and  multiply  and  imjiro\  o. 
some,  even  of  the  very  best  womt"  ,  believe  that  every- 
thing can  be  taught  by  book  ^i.  I  lecture,'  and  tested 
by  examination — that  memory  is  the  great  step  Id 
excellence. 

Can  you  teach  horticulture  or  agriculture  by  brok.s, 
Cf^..  descriljing  the  dilTerent  manures,  artificial  ami 
natural,  and  their  purposes?  The  being  able  to  know 
every  clod,  and  adapt  the  ai)i)ro])riate  manure  to  it, 
is  the  real  thing.  Could  you  teach  painting  by  giving, 
c.  C.  Fuseli's  lectures.''  Fuseli  himself  said,  when  asked 
liow  he  mixed  his  colours,  "Wi^^h  brains,  sir" — that 
is,  jiractice  guiiled  by  brains.  Hut  you  have  another, 
a  quite  other  sort  of  a  thing  to  do  with  nursing;  fnr 
vou  have  to  do  with  living  bodies  and  living  minds, 
and  feelings  of  both  boily  and  mind. 

It  is  said  that  you  give  examinations  and  certificates 
to  plumbers,  engineers,  etc.  But  it  is  impossible  to 
compare  nurses  with  plumbers,  or  carpenters,  or  en- 

'Miss  Ninhtinnalt'  is  grtMtly  niistaki-n  in  this  statement. 
Inste.nl  of  "woincn"  she  should  havf  said  "men,"  IhouKh 
thev  are  not  the  l)t.st. 


Miss  Nil:;htinL;alc'-^  W'rilini^s 


275 


1,'incers,  or  c\-eii  with  .i^'ardcncrs.  TIu'  main,  the  trr- 
nicndous  difference  is  that  nnrses  liave  to  dn  wiili  these 
livinj,'  bodies  and  rm  less  livinj,'  minds:  for  the  life  is 
nni  vc<,'etal)le  hfe.  nur  mere  animal  life,  hut  it  is  himian 
life — with  living',  that  is.  eonscious  forces,  not  electric 
or  [jravitatifin  forces,  hut  liuman  forces.  If  you 
examine  at  all,  you  must  examine  all  day  lonp.  current 
examination,  current  supervision,  as  to  what  the  nurse 
is  doing  with  this  douhle,  this  damaged  life  entrusted 
tn  her. 

The  physician  or  surgeon  gives  his  orders,  generallv 
lii'^  conditional  ordc'-^.  perhaps  nncc  or  twice  a  dav, 
perhaps  not  c\en  that.  The  nurse  has  to  carrv  them 
out,  with  intelligence  of  conditions,  everv  minute  of 
the  twenty-four  hours. 

The  nurse  must  have  method,  self-sacriticc,  watch- 
ful activity,  love  of  the  work,  devotion  to  dutv  (that 
is.  the  service  of  the  good),  the  courage,  the  coolness 
'1  the  soldier,  the  tenderness  of  the  mother,  the  ab- 
<rme  of  the  prig  (that  is,  never  thinking  that  she  has 
attained  perfection  nr  that  there  is  nothing  better). 
Slu'  must  have  a  threefold  interest  in  her  work  an 
intellectual  interest,  in  the  ease,  a  (much  higher) 
hearty  interest  in  the  patient,  a  technical  (practical) 
interest  in  the  patient's  care  and  cure.  vShe  must  not 
I'lok  upon  jiafients  as  made  for  nurses,  but  upon 
mirsesas  made  for  patients. 

There  may  als<i  now  I  onl\  ^.t_v  nhiy  with  all  tliis 
dependence    on    literary    lore   in    nurse    train  ng,   he 

'tal  danger  of  hiing  satisfied  with  diagnosis,  '.r 
with  looking  too  much  at  the  pathology  of  the  case, 
without  cultivating  the  resource  or  intelligence  f»)r  the 
thousand  and  one  means  of  mitigation,  even  where 
''  ■  yr  is  no  cure. 


A  History  of  Nursini. 


And  never,  nt-'.or  kt  the  nurse  fnrc'et  that  she  must 
look  fur  the  t';iu!t  <'i  the  nursin.cr,  as  much  as  for  the 
fault  of  the  disease,  in  the  symptoms  of  the  patient. 

(5)  Forty  or  fifty  years  ago  a  hospital  was  looked 
upon  as  a  b<ix  to  hold  patients  in.  The  first  question 
never  uas,  Wdl  the  tiospital  d.o  tliem  no  harm?  luior- 
mous  strides  have  had  to  be  made  to  build  and  arrantre 
hospitals  so  as  to  do  the  patients  no  sanitary  or  insani- 
tary harm.  Xow  there  is  danger  of  a  hospital  being 
looked  ujion  as  a  bo.\  to  trrtin  nurses  in.  Ivnormous 
strides  must  be  made  not  to  do  th  .'m  hrrm,  to  give 
them  something  that  ean  really  be  calleti  an  "all- 
around"  training. 

Can  it  be  jjossiMe  that  a  testimonial  or  certificate 
of  three  years'  so-called  training  or  service  from  a 
hospital — any  !-  nital  with  a  certain  number  oi  beds 
— can  be  acce,  is  sufficient  to  certify  a  nurse  for  a 

place  in  a  pul.A.t-  reg.ster?  As  well  might  we  not  take 
a  certificate  from  any  garden  of  a  certain  number  of 
acres,  that  plants  are  certified  valuable  if  they  have 
been  three  years  in  the  garden  ? 

(6)  Another  danger --that  is,  stereotyping,  not 
progressing.  "  Xo  system  can  endure  that  does  not 
march."  Are  we  walking  to  the  future  or  to  the  past? 
Are  we  progressing  or  are  we  stereotyping?  We  re- 
member that  we  have  scarcely  crossed  the  threshold 
of  uncivilised  civilisation  in  nursing:  there  is  .Uill  so 
much  to  do.      Don't  let  us  stcreot  vpc  nu-iliocrity. 

To  sum  up  the  dangers; 

I  On  one  side,  fashion,  and  want  of  earnestness, 
not  making  it  a  life,  but  a  mere  interest  consequent  on 
this. 

II  On  the  other  side,  mere  money-getting:  yet 
man  dues  not  live  bv  bread  alone,  still  less  woman. 


Miss  Nightiiii^alc's  Writin_L,''S        2-]-] 

III.  Makinv,'  it  a  profession,  and  nut  a  callin,*,'.  Xut 
making'  your  "callinLr  :in'i  clet-tion  sure";  wanting,', 
especially  wiih  private  nurses,  the  eoninmnitv  of  feel- 
ing; of  a  common  nursin<^  home,'  pressing  towards  the 
"mark  of  your  calling',"  kcepinj:,'  up  the  moral  tone. 

IV.  Above  r.ll,  ilanL,'er  nf  niakini,'  it  bonk-learn- 
in.Ljanci  lectures  not  an  apprenticeshijj,  a  v,(jrkshop 
]'racticc. 

V.  Thinkini.;  that  any  hosjiital  with  a  certain  num- 
ber of  beds  may  be  a  bwx  t'<  train  nurses  in,  regardless 
111  the  conditions  essential  to  a  sound  hospital  organ- 
isatinn,  especially  the  responsibility  of  the  female 
head  for  the  conduct  and  discipline  of  the  nurses. 

VI.  Imininent  danger  of  stereotyping  instead  of 
progressing.  "  Xo  system  can  endure  that  does  not 
inarch."  Objects  of  registration  not  capable  of  being 
gained  by  a  public  register.  Who  is  to  guarantee 
our  guarantors?  Who  is  to  make  the  inquiries?  \'ou 
might  as  well  register  mothers  as  nurses.  A  good 
nurse  must  be  a  good  woman. 

V.  The  health  of  the  unity  is  the  health  of  the 
community.  Unless  you  have  the  health  nf  the  unity 
ihcre  is  no  community  health. 

Competition,  or  each  man  for  himself  and  the  devil 
against  us  all,  may  be  necessary,  we  are  told,  but  it  is 
1'  I.'  enemy  of  health.  Combination  is  the  antidote  — 
combined  interests,  recreation,  combination  to  secure 
the  best  air,  the  best  food,  and  all  that  makes  life  use- 
ful, healthy,  and  happy.     There  is  n(j  sucli  thing  as 


\:\  i:c  L'liilcd  States  it  is  [.roiiahlo  th.it  priv.ite  nurses  are 
.i^'hor  education  th.m  in  Eti^jhind  On  the  other  hand, 
y  have  the  doubtful  dignity  of  graduates. 


1^ 


■s 


A  1  li^loiA  of  Nursing- 


indejtcnilt'ncc.  As  far  as  wc  art'  successful,  our  success 
lies  in  cnmbinatiDn. 

Tlie  Cliicaj:!)  Exliibition  is  a  fjreat  combination 
from  all  parts  of  the  world  to  ])rove  the  dependence 
of  man  on  n'.an. 

What  a  lesson  in  c  unbination  the  United  States 
lU'U'c  tau.L,dit  to  the  whole  world,  and  are  teachingi 

In  all  de])artnients  of  life  there  is  no  a])prcnticeshii) 
excejJt  in  the  worksho]).  Xo  theories,  no  book-learn- 
in.L,'  can  ever  dispense  with  this  or  be  useful  for  an\- 
thinJ,^  e.\ceiit  as  a  steppini,^-stonc.  And  rather  more 
than  t'or  an_\-thini,f  else  is  this  true  for  health,  Book- 
learninn;  is  useful  mily  to  render  the  ])racticrd  health 
of  the  health-workshop  intellis^cnt,  so  that  every 
stroke  of  work  done  there  should  be  felt  to  be  an  illus- 
tration of  what  has  been  learned  elsewhere — a  driving; 
home,  by  an  exjierience  not  to  be  fortjotten,  what  has 
bein  ,f,Mined  by  knowled},je  too  easily  forgotten. 

Look  for  the  itleal.  but  put  it  into  the  actual  --"nut 
by  vajjue  exhortations,  but  by  striving'  to  turn  beliefs 
into  ener^jies  tliat  would  work  in  all  the  details"  of 
health.  The  superstitions  of  centuries,  the  bad  hab- 
its of  j,'enerations.  cannot  be  cured  by  lecture,  book,  cr 
examination. 


VI,  May  our  hojies  be  that,  as  every  year  the  tech- 
nical (lualifications  constitutinj^  a  skilful  and  (jb.serv- 
inp  nurse  meet  with  more  demands  on  her  from  the 
physicians  an<l  surircons.  ])rojjress  may  be  ttiade  year 
by  year,  and  that  not  only  in  technical  thinj,,'s,  but  in 
the  qualifications  which  constitute  a  jjood  and  trust- 
worthy woman,  witlumt  which  she  cannot  be  a  good 
nurse.  Examination  pajicrs,  examinations,  public  re^'- 
istration,  grailuation,  form  little  or  no  test  of  these 


Mi»  XiL(htiiij^MK's  Writiii^-s       2-;q 


cjiKililications.  The  least  e(lucat(.'(l  c:(i\erness.  wiio 
may  not  be  a  .<,^m(i(1  nurse  at  all.  may.  and  jirobably 
will,  come  otY  best  in  e.xamination  i)aiiers,  while  the 
best  nurse  may  come  off  worst.  May  we  hojic  that 
the  nurse  may  understand  more  and  m')re  of  the  moral 
and  material  <(overnnunt  of  the  world  by  the  Supreme 
.Moral  Governor,  hi.Ljher,  better,  holier  than  her  "own 
acts."  that  tjovernment  which  enwraps  her  round. 
and  by  which  her  own  acts  must  be  led,  with  whit  h 
her  own  acts  must  aj^Tcc  in  their  due  {)roportion  in 
order  that  this,  the  hi^diest  hope  of  all,  may  l)e  hers; 
rai>injT  her  above,  i.  c,  puttin.s,'  beneath  her.  dan>,'ers, 
fashions,  mere  money-.^ettini,'.  solitary  monev-j^a-ttint,'. 
hut  availin.LT  lierself  of  the  hi-h  helps  that  mav  be 
jri^en  her  by  the  sympathy  and  support  of  ^tun] 
'dinmes";  raising  her  above  intrusive  [jersonal  morti- 
fications, pride  in  her  own  ])rotieiency  (she  mav  ha\c 

■ist  pride  in  her  own  doctors  and  trainini^  s(  luioh, 
sham,  and  clajj-trap;  raising  her  to  the  highest 
"grade"  of  all.  to  be  a  fellow-worker  with  the  Supreme 
(ioocl,  with  Clod!  That  she  ma\  be  a  "graduate"  in 
this,  how  high!  that  she  may  be  a  "grailuatt-"  in 
words,  not  realities,  how  low! 

We  arc  only  on  the  threshold  of  nursing. 

In  the  future,  which  I  shall  not  see.  for  I  am  <iM. 
may  a  better  way  be  opened!  .May  the  methods  b\- 
which  every  infant,  every  human  being,  will  have  the 
hest  chance  of  health,  the  me  hods  by  which  every 
sick  person  will  have  the  best  chance  of  rec(j\ery,  be 
learned  an<l  practised!  Hospitals  are  only  an  inter- 
mediate stage  of  civilisation,  never  intended,  at  all 
»•"  ents.  to  take  in  the  whole  sick  population. 

.May  we  hope  that  the  day  will  cotne  when  every 
iiinther  will  become  a  health-nurse,  when  every  poor 


;So 


A  History  of  Nursing- 


sick  person  uill  have  the  f)j)finrUinitv  'if  a  share  in  a 
district  sick-nurse  at  lii.me!  Hut  it  will  not  lie  i-ut  of 
a  register:  the  nurse  \v  11  not  be  a  stereotyped  one. 
We  find  a  trace  of  nursing  here,  another  there;  we 
find  nothing  like  a  nation,  or  race,  or  class  who  know 
how  to  ]irovide  the  elementary  conditions  demamlcd 
for  the  recovery  o{  their  sick,  whose  mothers  know- 
how  to  bring  up  their  infants  for  health. 

May  v>-e  hoj)e  that  v.hen  we  are  all  dead  and  gone 
leaders  will  arise  who  have  been  personally  experi- 
enced in  the  hard,  practical  work,  the  difficulties  and 
tlie  joys  of  organising  nursing  reforms,  and  wh(j  will 
lead  far  beyond  anything  we  have  done!  Mav  v,e 
hope  that  every  nurse  will  be  an  atom  in  the  hierarchy 
of  the  ministers  of  the  Highest .'  But  then  she  must  be 
in  her  place  in  the  hierarchy,  not  alone,  not  an  atom 
in  the  indistinguishab  e  mass  of  the  thousands  of 
nurses.      High  hopi's,  whic'i  Aill  not  be  deceived! 

Aside  from  ntirsiiig;  j^rop^T  Miss  Nightingale's 
sympathetic  interest  and  the  magic  power  of  her 
name  have  been  j^iven  to  innumerable  causes  and 
campaigns  of  right  against  wrong.  Among  such 
\\e  may  instance  especially  the  long  struggle  mane 
by  a  few  heroic  women  (tmally  suece.s.sfnl)  ff)r  the 
repeal  of  odious  laws  regarding  the  regulation  of 
vice  in  England.  .Miss  Xightingale's  name  was 
placed  on  a  petition  for  reperd.  She  has  also 
always  held  broad  impersonal  views  on  the  sub- 
ject of  public  service.  An  illustration  of  this  atti- 
tude is  given  Ijv  some  of  her  wnrds  in  Notes  on 
Nursing,. 

I  would  earnestly  ask  my  sisters  to  keep  clear  of 


Miss  Nightingale's  Writings       :;S! 


liMth  the  jargons  now  current  e\ery\vhere  (for  they 
lire  equally  jargons]:  tf  tlie  jar.i^on,  namely,  abcjut 
the  "ri.>,^hts"  of  women,  wliieh  urines  women  to  do  all 
that  men  do,  including  the  medical  and  other  profes- 
sions, merely  because  nun  do  it,  and  without  regard 
to  whether  this  is  the  best  that  women  can  do  ;  and  of 
the  jargon  which  urges  women  to  do  nothing  that 
men  do,  merely  because  they  are  women,  and  should 
be  "recalled  to  a  sense  of  their  duty  as  women,"  and 
because  "this  is  women's  work,"  and  "that  is  men's," 
and  "these  are  things  which  women  should  not  do," 
which  is  all  assertion,  and  nothing  more.  Surely 
woman  should  bring  the  best  she  has,  whatever  that 
i>.  to  the  work  of  God's  worhl,  without  attending  to 
cither  of  these  cries.   .  Hut  you  want  to  do  t!ie 

thing  that  is  good,  wliether  it  is  "suitable  for  a  wo- 
man" or  not. 

It  d<ies  not  make  a  thing  good  that  it  is  remarkable 
that  a  woman  should  have  been  able  to  do  it.  Neither 
does  it  make  a  tiling  bad,  which  v,i  mid  have  been  good 
had  a  man  done  it,  that  it  has  been  thmc  by  a  woman. 

Oh,  leave  these  jargons,  and  go  your  way  straight 
to  God's  work,  in  simplicity  and  singleness  of  heart.' 

She  ha.s  boon  a  life-long  advocate  of  suffrajre 
for  women,  .say.s  the  Woman's  Journal,  and  when 
asked  one  time  for  her  reasons,  said: 

I  have  no  reasons.  It  seems  to  me  almost  self- 
evident,  an  axiom,  that  every  householder  and  tax- 
payer shou  i  have  a  voice  in  the  expenditure  of  the 
monev  we  pay,  including,  as  this  doe.-,  interests  the 
most  vuci  to  a  lunrian  being. 

'  Sotcs,  p.  135. 


2S2 


A  I  Ii^t(ii"\-  of  Xursiii'j 


An  intcn'stiiiL,^  trsnninnv  t'l  licr  ronstaiit  intcM'- 
c'st  in  am!  attnuion  in  ]iro<,n-essi\X'  sncia]  sti'])s  was 
a  letter  written  by  her  in  iScjj,  to  a  puhlie  oflieial, 
in  whieh  slie  saii] : 

We  must  create  a  public  opinion  whieli  will  (ln\c 
tile  Government,  instead  of  the  Government  havintj 
to  drive  us — ,-in  cnliLrhtened  ])ublic  opinion,  wise  in 
princiiJles,  wise  in  details.  Wr  jiaii  the  County  Coun- 
cil as  beins  or  becomintj  one  of  the  stron^'cst  engines 
in  our  favour,  at  once  fathering  and  obcving  the  great 
imjnilse  for  national  health  against  national  and  local 
disease.  For  we  have  leanuil  that  we  have  national 
health  in  our  own  hand — local  sanitation,  national 
health.  But  we  have  to  contend  against  centuries  of 
superstition  and  generations  of  indifference." 

One  of  the  nmst  interesting  pul  ijishc^d  expres- 
sions of  her  \ie\\s  on  social  questions,  showing,  as 
it  does,  that  from  her  siek-rooni  she  constantly 
with  eagi'i-  Iv  \\)v  i'  'llov^fd  tlir  tendencies  of  jjolitica! 
and  \-Mluntary  social  action,  is  an  article  written 
in  187 .; : 

What  will  this  world  be  in  August,  iqqq  .  .  . 
what  shall  we  wish  then  to  have  been  doing,  ami  what 
shall  we  wish  not  to  have  been  doing?  .  .  .  Will  the 
views  (if  family  life,  of  social  life,  of  the  liuties  of  social 
life,  be  the  same  then  as  now'  Will  the  distribution 
of  riches,  of  poverty,  of  the  land  ...  be  the  same 
then  as  now?  Will  religion  consist  then,  as  now,  not 
in  whether  a  man  is  "just,  true  and  merciful"  .  .  . 
but  whether  the  man  "had  believed  what  he  was  toKl 
to  believe"    .    .    .     What  shall  we  then  wish  to  have 


Miss  Ni-'htinijalc's  WritiiV'S 


28- 


lieen  (loin;;  imu  '  Is  it  rcadins:;  or  writine  mere  arti- 
Ivs'  .  .  .  (jr  is  il  workiiii,',  siil\'in,i,'  hy  real  personal 
wi'rk  the  prcat  (luestions,  <ir  rather  jirobletiis,  which, 
as  thcv  are  sn]\-cil  or  unsoh-ed.  will  make  iqoq  what 
it  will  be? — such  as  depaiiiierisatinn,  tdlunisalion, 
.  liieation,  refnrniation,  le.s^islatinn.  niakini^^  reli,<,'i')ii 
aii'l  God  a  real  i'ers<inal  ]iresenee  amon.t,'  us,  not  a 
lielief  in  a  iret'l.  a  .LjoiiiL;  to  a  room  or  church,  "tor 
what  we  call  our  ]ira\'ers." 

In  this  ailiele  all  "f  her  life-h  niL,^  eleineiUal.  tfr- 
\ent  hatrnl  <  if  sham  ainl  ei  )in-e!itional  lies  breaks 
forth  a,L;ain  :  il  is  an  exprcssinn  <  >\  re\n]t  ot  rejec- 
tion of  curren.t  sniuuiiess  1  if  thought. 

Reli,L;ion,  sermons,  consist  now  (.'ither  in  telling  iis 
•  !ielie\e  what  we  are  "  Xi  'M  to  Ik  licve."  and  to  attend 
tiie  "means  of  j^race"'-  ne\'er  enquiring;  whi'ther 
tliere  be  not  other  "means  of  .t,'ra(e."  or  else,  in 
tcllinjf  us  to  ]>raetise  certain  so-called  relit^'ious  or 
<'"ial  \irtues  hi  that  "  state  of  life"  (or  state  of  mind) 
■•'I  which  it  has  been  ])leased  to  call  us,"  leavin.tj  life 
just  as  it  is,  takin.<j  for  .^ranted  that  that  "  state  uf  life  " 
is  the  one  we  arc  honi  into. 

But.  in  logQ,  shall  we  not  wish  to  ha\c  worked  out 
wb.at  life,  family  life,  social  life,  ])olitical  life,  should 
he.  and  not  to  have  taken  for  },'ranted  that  family 
life,  social  life,  i)olitical  life,  are  to  be  as  they  are,  and 
we  to  get  as  much  enjoyitient  out  of  them  as  we  can? 

...   It  never  seems  to  be  thoui,dit  that  it  is  more 

difticult  to  discover  the  ways  of  creatine^  the  kint^niom 

"f  I'eaven  tijion  earth  than    to  discover  the  ways  of 

•K'  solar  system — yet   no  one   would   e\er  think   of 

rt-eommendins;  the  studv  of  astronemn'  to  be  lairsued 


hi 


>84 


A  History  of  Nursing 


in  the  weak,  pretentious,  sententious  manner  !hat  we 
arc  prcaehed  to  about  pursuing  Life.  Vet  lite  is  a 
liardcr  study  than  astronomy,  if  we  are  really  to  suc- 
ceed in  it,  really  to  succeed  in  bringing  about  a  little 
corner  of  the  kingdom  of  liea\  en. 

We  are  never  lectured  about  the  study  of  anything 
else  in  the  wild,  wishy-washy,  womanish  terms  that 
we  are  preached  to  about  life.  And  this  is  thought 
Christian — as  if  Christ  had  n<it  been  the  boldest 
preacher  that  ever  went  about  reforming  life.   .   .  . 

In  a  new  and  striking  form  she  re-embodies  her 
life-long  insistence  on  thomugh  i)reparatifin  as 
necessary  for  efficiency : 

Freedom  is  indeed  not  doing  as  we  like,  not  everv- 
body  following  his  or  her  own  way,  even  if  tliat  were 
possible,  but  self-control.  Self-control,  plus  a  con- 
trol or  command  of  our  subject,  gives  "freedom";  but 
a  person  who  has  no  control  over  any  subject,  or  right 
use  of  any  faculties,  cannot  have  freedom.  It  ^.H  comes 
to  the  same  thing,  viz.,  tiie  necessity  of  doing  what 
we  do  well,  of  what  we  do  being  what  is  well  to  do,  if 
'.ve  ,  -;;  to  attain  what  is  commonly  c''.;;d  "humility" 
(disregard  of  self,  useful  care  for  othc.o,  efTicietit  ser- 
vice of  God  and  of  our  brethren). 

The  work  of  Arnold  Toynhee  had  ex  idenlly 
aroused  her  keenest  sympath)-.  She  alludes  to 
his  work,  without  mentioning  him  by  name,  and 
urges  the  need  of  social  \\<]rkers; 

The  kingdom  of  hca^•en  is  within,  but  no  one 
laboured  like  Christ  to  make  it  without.  He  actually 
recommended  people  to  leave  their  own  lives  to  do 


Miss  Ni,c^htin;j^alc's  Writings       :!S5 


t!'.is,  so  much  was  he  ]>enc'tratcd  by  the  conviction, 
filled  by  the  enthusiasm,  that  we  must  alter  the  "  state 
fif  life  "  (not  conform  to  it,  no,  oh  thrice,  ten  times,  nol 
a  hundred  times,  no')  into  wliich  we  arc  born,  in  ortlcr 
/()  hring  about  a  ''kinj:^dom  of  heaven."  Xcvcr  was 
anything  less  like  remaining  within  good  intentions 
than  Christ's  teaching,  than  Christ's  example.  .  .  .  We 
must  go  forth  into  the  world  to  bring  about  the  king- 
i'lm  of  heaven.  .  .  .  If  we  Jz'J  the  things  peop'e  now 
prate  about,  write  about,  speechify,  debate,  report 
about,  that  uvuld  be — .administration. 

She  closes  with  .sonic  of  her  own  inimitable 
aphorisms — kecn-e(l<.;e(l  as  a  surp^con's  knife.  She 
cf)mments  on  the  widespread  epidemic  of  fruitless 
talk  and  compares  the  common  tendency  to  over- 
look the  most  real  anfi  necessary  for  the  less 
important  to  the  words  of  a  famous  surgeon,  who 
said  of  a  patient  on  whom  a  notable  operation  had 
been  performed,  "He  died  cured." 

Discussion  nowadays  almost  precludes  considera- 
tion— it  leaves  no  time  for  thought.  .  .  .  The  only 
discus'^'on  that  can  be  of  any  use  is  that  between  per- 
sons who  have  thought  out  something  about  the 
subject,  who  luring  some  contribution  of  individual 
thfiught  or  of  personal  knowledge  to  the  coinmon 
stock.  What  a  valuable  rule  it  would  be,  for  ev'ery 
half  hour  s])ent  in  discussion  spend  two  previous  half 
hours  in  thought! 

Discussion  will  not  govern  the  world,  nor  even  a 
single  home  in  it. 

Language,  savs  Talleyrand,  was  given  us  to  conceal 
tiur  thoughts.      Kven  that  is  better  than  what  we  see 


286 


A  I  lislory  u(  Nur^in- 


now.  wIrmi  lati^'ua-jc  sct-iiis  to  Ir>  ;,'ivcn  iis  to  conceal 

our  want  oi  t  noughts. ' 

To  sum  up  such  .(  character  as  Miss  \'it,'htiii- 
;;alo'.s,  as  (Hsplayc'I  in  her  \vritinj,'s,  in  scattered 
personal  testimony,  and  in  the  multiplied  proofs 
of  her  enert^Hsinj,'  influence  on  others,  is  a  task 
worthy  of  more  able  minds  tlian  any  lha<  have 
yet  attempted  it.  So  rich  a  conihinal  ion  as  hers 
has  rarely  been  found  of  dominant,  masterful 
intellectual  ,11,'enius,  of  creative  thous,dit,  of  indi- 
vidual executive  ability  to  transform  thouj^ht  into 
efi'ective  action.  whiK'  health  lasted,  .and.  when 
health  vanished,  still  to  effect  this  transformation 
throu}j;h  a  rare  force  of  influence  on  others;  nf 
maternal  tenderness  for  all  helpless  and  suffering 
life,  of  cosmopolitan  synij)athies  and  divcnso 
interests,  of  a  tjlorious  capacity  for  righteous 
anj^er.  with  kindliness,  and  forj^etfulncss  of  self: 
of  free,  tearless  ojjinions.  These  characteristics 
su.^j^est  a  personality  of  rare  proportirms,  for  whose 
heroic  lines  her  keen  satirical  wit.  her  se\cnty  of 
judj,'ment  of  incapacity  an<l  futility,  her  intoler- 
ance of  mediocrit\-  and  common] )laeeness  form 
only  the  needed  shade  and  colon rinj,,'.- 

'  A  Sub-' .\<>tt'  of  Inlrrri)),;.iti(>n,'  by  I'lorrnte  XiKfltitlfj.ilc. 
/''rasrr's  .\/<ji;.J-(i/i'.  July.  1X7^ 

>  Dr  Alinili.im  JacoM  has  charaoUTisi-cl  Hit  as  one  "who 
has  i>ri)Vi(l  Iiow  to  hi(()nic  iminDrtal  withmit  enjoying  high 
ittlki',  or  i>I,iyinn  <>n  a  i-.innnn,  or  tyrannising;  nations,  or 
being  born  on  a  throne." 


chapti:r  VI. 


MISS    XTCHTINC-.AI.I-  S    CO-WORKERS. 


THE  most  pitt'ou.s  of  the  caravansaries  for  the 
sick,  and  the  \-ery  last  to  b^'  c^red  for.  were 
tlu'  infirmar}-  wards  of  the  jjreat  workhouses  (ir 
iihiishouses.  These,  the  last  refui^'e  of  the  incurable 
and  chronic  pnor,  beyond  which  no  further  trans- 
fer was  possible  save  into  the gra\'e,  appear  to  ha\e 
been  left  quite  without  the  i)ale  of  human  pity  or 
I'ven  interest,  until  as  late  as  the  middle  of  the 
nineteenth  century,  when  a  small  ^roup  of  women, 
ihief  and  nvi.st  untirinj^  amoni^  whom  was  Miss 
Liniisa  Twining,  be.ijan  a  veritable  siege  to  break 
down  the  walls  of  oflicial  callousness  and  ignorance 
bdiind  which  the  dependent  poor  were  virtuallv 
imprisoned.  This  siege  has  lasted  throughout  the 
halt-century,  f(jr  Miss  Twining  still  lives,  with 
till'  haiijjiness  of  knowing  that  the  battle  has 
lull  won,  though  final  outposts  of  stupidity  still 
Mniain  to  be  taken. 

Tlie  whole  story  of  these  women's  persistent 
and  undiscouraged  elTort.s — of  the  obstacles  place<l 
in  their  way ;  of  the  rebuffs  which  a  jealous  olhcial- 

>m,  fcari.ng  the  light  of  public  inc]uiry  and  resent- 

887 


288 


A  llistorv  of  Xursiii' 


ing  criticism,  ofTered  them;  nf  their  long,  slow, 
paticntly-striven-for  gains  and  advances,  resulting 
in  the  gradual  separation  of  the  sick  from  the 
other  dependents  and  in  the  introduction  of  en- 
lightened methods  of  caring  for  all  classes  of  de- 
pendents—is a  most  impressive  one,  and  it  is  safe 
to  say  that,  had  it  been  a  campaign  of  war  between 
nations,  it  would  have  been  found  worthv  of  \-ol- 
umes  upon  volumes  of  descrijjtion. 

Miss  Twining 's  work  has  gone  side  by  side  and 
hand  in  hand  with  the  reform  of  nursing,  and  to- 
day, though  there  is  still  much  to  be  done,  a  mar- 
\ellous  change  has  taken  place  in  the  workhouses, 
many  of  which  now  have  hospitals  and  trained 
nursing  of  distinguished  excellence. 

Miss  Twining  began  visiting  the  workhouses  in 
1853.  She  first  went  to  see  an  old  woman  whom 
she  had  known  at  home,  and  from  this  circum- 
stance may  be  said  to  date  the  beginning  of  all 
systematic  effort  for  the  organised  visiting  of  work- 
houses both  in  London  and  in  the  country.' 

A  few  years  later,  Miss  Elliott  and  Miss  Frances 
Power  Cobbe  also  becoming  deeply  interested  in 
the  problem  of  the  incurably  ill  poor,  indepen- 
dently, at  first,  of  Miss  Twining's  work,  did  much 
to  stir  popular  sympathy  by  issuing  (in  1861)  the 
first  published  articles  ad\-ocating  the  separation 
of  incural)lo  and  chronic  patients  from  the  ordi- 

'  Rrcollrclions  of  \\'orkltot4se  Visitini;  and  Mawgiug  dm- 
i»/^  Turiit\-;'ivc  Years,  by  I^iii«a  Twining.  Kc(ian  Paul  &  Co.. 
Loiiilon.  1880,  p.  6. 


Mi-s  Xii^htin-alc's  Co-Workers     289 


nary  workhouse  populatir)n,  and  ur^ino;,  further, 
that  official  permission  should  be  ^^'wcn  for  private 
philanthropy  to  introduce  little  comforts  and 
pleasures  for  the  .k;  for,  incredible  as  it  may 
seem,  this  simple  effort  of  goorl-will,  when  tried  by 
individuals,  met  with  suspicion  and  peremptory 
refusals  from  the  officials  in  charge  of  workh'-uses. 
Miss  Elliott  and  Miss  Cobbe  together  wrote  a  cir- 
cular letter  embodying  these  propositions,  and 
sent  it  to  some  six  hundred  and  sixty  Unions 
(guardians  of  the  poor),  and  through  their  elTorts 
the  Association  for  the  Promotion  of  Social  Science 
which  had  been  founded  in  1856  was  enlisted  in 
the  cause  of  workhouse  reform.' 

Thatwas  a  timewhen  the  most  ordinary  prompt- 
ings of  common-sense  and  humanity  were  regarded 
in  some  quarters  as  visionary,  for  Miss  Cobbe 
(who  tells  many  ludicrous  and  humorous  tales) 
recalls  a  dictum  of  the  Moniiufi  Post,  whose  editor 
regarded  one  of  the  ablest  men  in  England  as 
unquestionably  "cracked"  because  he  believed 
that  it  was  possible  to  reform  juvenile  criminals.' 
^  The  wretchcfl  system  (  nursing  l)y  d/unken 
a  (1  degraded  paupers,  then  pre\alent,  was  stead- 
ily as.sailed  by  all  these  women.  Miss  Giblic 
speaks  of  the  "mon.ster  evil  of  the  unqualified 
nurse,"  and  concentrated  her  interest  uptm  this 
special  department. 

'  Lilr  of  Frances  renter  Cobbe.  as  told  by  Herself.     Swan 
"^nncnschein,  Ix)nrlon,  1^04.  p.  315. 

S  >ctal  Srtencc  Congresses  and  Women's  Part  in  Them." 
1  ranees  Power  Cobbe,  Macmillaii's  Magazine,  1861 
VOL.  II  —ig. 


290 


A  History  of  Nursing 


She  and  Miss  Elliott  witc  the  pamphlets 
The  V  house  as  a  Host>ital,  Destitute  Iiuiira- 
hles.  .e  Sick  in  Workhouses,  etc.  As  time 
wnit  on  Miss  Cohbe  became  absorbed  in  other 
interests,  while  Miss  Twinin^i;,  \\h<>  fmin  thr  first 
had  applied  herself  to  no  less  a  pur])ose  than  that 
of  revolutionisinj:^  the  entire  Workhouse  system, 
made  the  nursinj,'  side  one  of  her  reforms,  but  not 
the  only  one.  In  fnllowinsi:  out  her  entire  pro- 
},n-amme  sin-  did  niueh  tu  induce  a  better  class  of 
Women  to  take  up  TUii-sin^.  Her  panijililtl  .V;(r,<;- 
/«,;'  for  the  Sick,  icith  n  Letter  to  Wmtu]  Women. 
London.  1861,  is  a  slirrinj,'  ap])eal  t"  the  latent 
tenderness  of  human  nature  and  L^ixis  a  jjitiful 
])ieture  of  the  dreadful  conditions  in  the  work- 
houses. 

What  some  r)f  these  conditions  were  may  bo 
j,'athered  from  official  reports.  In  1865  a  report 
of  the  Poor  L;iw  Board  printed  for  the  Hou.sc  of 
Commons  showed  6400  sick  in  fortv-one  London 
workhouses,  of  whom  one  third  were  p-.tients  suf- 
ferinj,'  from  acute,  curable  diseases.  To  this  mass 
of  patients  thi-re  were  seventy-one  paid  nurse 
(and  it  must  be  remembered  that  even  these  were 
of  the  (iamp  cla.ss),  some  workhouses  having  onlv 
out'  nurse  apiece.  ThirteiMi  of  these  institutions 
had  no  ])aid  nurses  at  all.  but  only  ])au])er  helpers, 
many  of  whom  were  over  sevetity  and  even  eij,'hty 
years  of  a},'e.  while  a  full  one  fourth  were  over 
si.Kty.  Nor  did  the  terni  "])aid  nrrse"  mean  any- 
thing very  desirable  from  the  labour  stan<lpoint. 


Mi.^s  Nii-'htirv'^ilc's  (  o-Wor 


:crs     201 


S'lnu-  nf  these  nurses  were  paid  the  lavish  sum  <if 
one  peTiny  per  week,  wliile  others  reeeivei]  extra 
diet,  or  elothiii},',  as  jiavmeTit,  The  iviedieal  ofti- 
ecrs,  who  souK^tiines  had  as  main-  as  threc^  hundred 
siek  under  their  care,  were  conipelled  to  buy  the 
medicines  for  the  ])atients  out  of  their  sahiries. 
I;  is  pr«)])alile  thai  in  thos(-  wards  treatment 
1)\-  the  excessive  use  of  druses  was  reijarded  with 
disapproval. 

The  instructive  thinj,'  aiiout  all  of  this  traj^'cdy 
is  that  the  male  officials  who  were  in  char^^e  quite 
m'nerally  felt  thai  these  metho<ls  were  satisfactory 
;ini!  that  improvement  was  unnecessary.  \fi 
wnnder,  with  such  standards,  that  the  visits  of 
wnmen  from  outside,  who  dared  to  crilic-ise  and 
(luestion,  were  re}^ar(le<l  as  uncndural)le  an<l  j)ry- 
uv^  im])ertinences. 

.\fter  \isitin^  the  south-western  counties,  with 
fiftv-eight  workhouses,  the  report  of  the  Poor  Law 
Inspector  said:  "Nursing  jjfcnerally  satisfactory; 
almost  every  infirmary  havinij  one  paid  nur.se,  and 
one  or  more  heli)ers."  .\nd  yet  this  district  had 
I  me  infirmarv'  where  there  wi're  two  hundred  and 
tiftv-one  sick,  includini,'  the  insane,  and  only  six 
nurses  with  nineteen  ])auper  helpers,  while  there 
was  no  ni,i,'ht  nursinjj  existent  in  any  of  the  work- 
Iv luses.  Anotht-r  Poor  Law  Insriector  mu.st  be  com- 
! nended  as  having  a  little  more  intelliLjence  than 
the  first  mentioned.  After  visit  inv,'  one  workhou.se 
where  no  division  was  made  betw(>en  medical  and 
'-'"'"''•al     patii'nt'^.   \vlii-i-i'    ihi'    Jtrli    w-.i-,    fl.i<'.ri| 


J9^ 


A  History  ufXui-sing- 


as  "va.ijranc\-,"  v,-Iion>  oiu-  wash-basin  and  one 
rf)ller-t(nv('l  were  allowed  wcekh-  in  wards  of  from 
ci.uht  to  fourteen  patients,  where  one  woman 
nurse  with  a  male  helper  had  charji^e  of  seventy- 
insane  patients  of  both  sexes,  and  where  one  other 
nurse  had  under  her  sole  care  one  hundred  and 
fifty  sick  persons,  this  man  of  rare  perception  and 
firmness  said,  "Althouj,^h  the  medical  officer  is 
contei-.ted  with  the  existing  conditions  of  the  in- 
firmary, I  do  not  consider  it  in  a  satisfactory 
state."  ' 

In  1855  a  proposal  was  made  by  a  society  of 
ph\-sicians,  of  whom  Dr.  Sicveking  was  foremost, 
to  train  the  numerous  able-bodie<l  women  in  the 
workhouses  as  nurses.  Miss  Twining  in  speaking 
of  this  could  not  approve  the  plan,  as  these  women 
were  usually  of  bad  character,  and  although  it  was 
sanctioned,  an.l  the  Board  of  Guardians  had  in- 
structions to  carry  it  out.  it  never  actuallv  took 
form.^ 

In  1857  an  asscx^iation  was  formed  through  Miss 
Twining's  efforts  called  the  Central  Society  for  the 
Promotion  of  Workhouse  Visiting,  and  two  years 
later  it  started  Us  own  journal.  This  society, 
affiliated  with  the  Social  Science  Association, 
carricfl  on  the  \v(jrk  of  workhouse  reform.  The 
greatest  circumspection  was  neccssar)-,  for  Miss 
Twining  relates  the  incident  of  a  body  of  visitor 

'  A  I  cntury  of  Nursing.  Reports  of  the  St.ito  ("haritifs  .\i.l 
Associ.Uion  of  New  York  State,  1S76.  Ouotirig  from  Parlia- 
mentary Papers,  vols  1\  -I.\i.,  1 806-08 

•  Ri.olUxlioiis,  J).  17 


Miss  Ni'^^htingalc's  Co-Workers    293 

being  dismissed  from  a  London  workhouse  in  con- 
sequence of  complaints  of  well-nigh  unendurable 
grievances  endured  by  the  inmates  and  noticed  by 
a  lady — a  person  of  influence  and  position,  as  well 
as  humanity.^ 

In  1866  the  Lancet  made  an  exhaustive  investi- 
gation into  the  sick  w;'-ds  (.)f  the  Lijndon  work- 
Ikjuscs,  and  brought  many  abuses  to  light. 

Not  until  1872  was  the  great  gain  made  of  hav- 
ing a  woman  appointed  as  otlicial  in  spector  of  the 
metropolitan  wurkhouses.^  Not  easily  could  men 
be  brought  to  see  the  necessity  of  this.  for.  as  Miss 
Carpenter  had  once  said,  "  Tliere  never  yet  lived 
a  man  S()  clever  but  the  matron  of  an  institution 
could  bamboozle  him  about  every  department  of 
lier  business."^ 

A  lovely  outcome  of  Miss  Twining's  work  was 
the  establishment  of  the  Flower  Mission,  wliich  has 
bruught  solace  to  so  many  bedridden  patients. 
Slie  soon  found  that  flowers  were  the  one  gift  that 
e.xcited  no  animosity,  and  began  in  1858  taking 
them  systematically  to  her  sick  people.  From 
this  grew  u]>  in  time  the  organised  society  nliich 
has  since  then  done  so  much  to  bring  joy  into 
ho';  'tal  wards. 

The  education  of  the  public  carried  on  by  Miss 
Twining  through  all  these  years  has  been  of  simply 
enormous  extent.  Her  most  irresistible  weapon 
has  been  the  absolute  accuracy  of  her  every  state- 


'R-xolLctions,  p.  60.      '  IbiJ.,  p.  66. 
'  Frances  Power  Cobbe,  Life,  p.  306. 


294 


A  I  li^tor\-  of  Xursini-- 


incnt.  Moderate  and  exact  in  tlie  use  nf  words, 
steadfast,  merciful,  and  con\-incing.  she  has  heen 
to  the  workliouscs  what  .Mis.  1m-\-  was  to  the  pris- 
ons and  Miss  Xit,ditini,ralr  ii.  ihe  hospitals. 

The  introduetio  of  f.-aitied  nur.siii;.r  ini,)  work- 
house iiilinuaries  was  acconiplislied  l.y  Ai.nirs 
I-^Hzabeth  Jones,  one  of  the  most  I)eIo\  ed  of  the 
jjioneers  in  nursin.^^  and  one  who  was  a  mart\T 
to  the  causr,  but  it  was  tlie  well-plannd  under- 
taking,^ of  Mr.  \Vm.  Ralhl)o!ie,  a  Huaker  of  Liver- 
pool, who  has  had  a  \-er_\-  important  part  in 
the  i)ro,i,rrcss  of  Eni,dish  nursin,i,r. 

The  iUness  and  death  of  his  wife  in   iS:;9  first 
turned  Mr.  Rathhone's  attention  to  nursin^,^     The 
thou<,du   of  how  the  poor   must  sutfer  in   ilhie.ss 
prompted  him  to  tr\-  an  experimmt,  and  he  en- 
j,'atT(-'d  the  woman  who  ha^l  hreii  lii.s  wife's  nurse, 
and  who  was  capable  and  kindl\-.  to  work  among 
the  poor  of  the  city.      He  pai<l  her  a  salai\-,  and 
provided  nourishment  and  appliances  for  the  .sick. 
The   results   eneourai^'eil    Iiim    aiid    he    wished    to 
extend  the  ser\-icc,  but  there  were  uo  more  nurses 
to  be  ha.l.      He  went  lo  Miss  .\i,<,rhtin-ale  f..r  ad- 
vici'.  and  she  counselled  In'm  to  tr\-  to  train  nurses 
in  Liwrj^ool,  at  the  RoNal  Inlinnarw     Thec-un- 
mittee  of  tli;-^   hospital   \'.is  anxious   to  improve 
the  nursin,^,  and  off^'red  Mr.   Rathboiie  a  seat  en 
their  boaid.       His  response  was  to  offer  to  build 
a  training;  scIkx.I  and  home  for  nurses  and  >,nve  it 
to  the  infirmary.       He  wrote  to  A.ijnes  Jones  to 
otfer  her  tl^'  position  of  superintendent,  but,  as  we 


Miss  Xightin;^alc"s  Co-Workers     295 

shall  sec,  this  was  not  t(»  be,  and  tinally  Miss  Mrrr\-- 
Wcathi'i"  went  to  St.  Thomas's  for  training;,  then 
t(ink  the  post,  and  gave  admirable  ser\iee  tliere. 
She  trained  nurses  for  the  wards  and  for  district 
nursing,  and  the  eit)'  was  (hvide'il  into  eiLi^hteen 
distriets  with  a  nurse  and  a  .ejroup  of  lad\'  \isitors 
for  each.  So  ])raetie-d  was  Mr.  Katlibonc  that 
for  a  whole  year  he  made  rotmds  re<^ularlv  with 
some  one  of  the  nurses,  to  see  conditions  for 
lumself. 

The  next  thinii;  tliat  imprrssed  In'm  vras  to  learn 
that  the  ])oor  alihorrrd  tht'  thon,L;hl  of  <join,i,f  to 
tlk'  parish  inhrmarw  and  he  studic*!  its  conditions. 
There  were  tweh-e  hmidred  sick  tliere,  in  every 
.st;i,^e  of  misery,  and  none  but  pauptr  imtraine(I 
help.  Mr.  Rathbone  urjjjed  bringing,'  in  a  trained 
superintemlent  \\'ilh  a  tironp  of  nurses,  and,  ;is 
the  authorities  were  \-ery  unwihiiiL:  to  incur  an\- 
expense,  he  olfere<l  to  defra\-  the  whole  cost  of  the 
experiment  for  thri'e  wars'  time.  Thev  a,>;reed  to 
this,  and  he  now  offered  this  second  .and  infiniul\- 
inorediflicult  ])ieee  of  work  to  A,L,nies  fones,  seetn\'d 
twelve  Xijfhtinjfale  nurses  to  assist  her,  and  on  the 
i6th  of  May,  iS()-..  this  little  ,t,'rouj)  of  Womc'u  lie- 
'^:m  their  reno\-ation  of  the  infirmar\-  with  eigh- 
teen probationers  and  fift}-four  of  the  ohl  jiauper 
nurses.' 

Agnes  was  born  in  Cambridgi-  in  i8_:;3,  and  from 
her  ear]\-  girlhoodi  she  \vas  restless  with  the  ea*rer 


'  William     Ratltbone:     A    Memoir.   l>y    EkMiior    F.    Rath^ 
tiont.    Macmillan  &  Co.,  Loiulon.  11)05,  PP   '5<^-i"3- 


196 


A  History  of  Nursini- 


desire  to  he  of  real  usefulness.     Beside  a  natural 
Kift  for  brinj^nng  help  and  cluvr  to  those  aroun.l 
her  she  was  also  cjf  excellent  executive  ability  an<! 
mental  acumen.  She  was  deeply  imbued  with  the 
excessive  evantrdical,  sentimental  pit-ty  j^revalent 
at  that  limt^  (the  continuous  outpourin<,^s  of  which 
ill  sprrch  and  writinsjjs  seem  now  so  self-conscious 
and  imctuous),  but  had  the  true  missionar}-  spirit. 
In  her  travels  on  the  continent  she  visited   Kai- 
serswerth    and    other    deaconess    establishments, 
and   was   at    first   greath-    drawn    to   that    life, 
though   later,  as   she  recorded  in  her   diary,    she 
concluded    that   one    coul''    do    as   well    out    of 
as    in  the   deaconess   order.       For    seven    vears 
after  her  visit  she  longed  to  go  to  Kaiserswerth  for 
training,  and  at  last  her  family,  who  were  of  the 
leisured   and    cultured    class,  rather  unuilling  to 
ha\e  her  take  this  then  unusual  step,  consented, 
and  she  spent  a  year  there,  from  i860  to  1861. 
Her  letters  from  Kaiserswerth.  and  her  description.s 
of  the  life  are  very  interesting  and  give  realistic 
and  graphic  pictun-s  of  the  daily  nnind.     While 
in   training  a   numl)er  of  opportunities  of  work 
offered  themselves  to  her — one   to   go  to   Syria, 
another  to  help  Mrs.  Ranyard  in  the  Bible  Mission 
and  district  we/k,  and  Mr.  Rathbone's  first  offer 
to  come  to  Liverpo(.)l. 

She  felt  drawn  to  each,  as  an  ardent  explorer 
does  to  new  countries,  but  her  chief  purpose  then 
was  to  prosehtise.  It  cannot  but  strike  one  oddh' 
that  she  should  write  to  Mr.   Rathbone,  himself 


Miss  Nightin<^^alc's  Co-Workers    2^^ 


one  of  llu'  salt  of  th 


mss. 


this  p 


e  earth,  a  wn'  j)iHar  of  orooil- 
^'ou  send   me  the 


edaiitic   loiu- 


<,rr()ur.:!  plan  of  the  buildint^,  but  I  wouM  ask.  Is 
its  foundation  and  corner-stone  to  be  Christ  and 


Ilim  crucified,  the  only  Saviour?     Is  the  Christian 

training  of  nurses 

skill  the  secondary  ot)]ect: 


t')  be  the  primary  and  hospital 
.   .     I    shall  not  tni- 


"k  in  any  work  whose  threat  aim  is   not  ol 


")eni- 


to  the  c 


dice 


creature. 


omnianil 


Preach  the  (iospel  to  every 


As  the  results  of  this  attitude  mi,L;ht  have  Wvn 
doubtful  in  hos})ital  ^vork,  the  plan  went  no  further 
tlu'n,  and  Aj^uies  coinplcli'd  her  term  at  Kaisers- 
werth  and  returned  to  London.  She  became 
more  and  more  attracted  to  the  tlefniite  W(jrk  of 
nursing,  and  consulted  Mi.ss  Nightingale  about  the 
advisability  of  entering  St.  Tlionias's  for  the  train- 
ing. Her  family  was  unwilling  to  ha\-e  hvv  take 
this  step,  and  even  she  herself  hesitated.  ])artlv  be- 
cause of  the  social  inferiority  of  most  of  the  older 
type  of  nurses;  but  at  last,  after  some  Avork  with 
.Mrs.  Ranyanl  in  the  Mission,  and  more  tra\'els  to 
centres  of  work  and  training  abi-(iad.  her  mother 
finally  consented  and,  having  lirst  had  a  personal 
interview  with  Mr.  Rathbone,  she  went  to  St. 
Thomas's  as  a  Nightingale  nurse,  and  afterwards, 
with  twelve  other  Nightingale  nurses  revolution- 
ised the  great  W(_irkhouse  infirmar}-  at  Li\"erpool, 
established  order,  training,  a  moral  atjnos- 
phcre,  cheerfulness,  cleanliness,  and  good  nursing, 
giving  a  wonderful  demonstration  of  what  can  be 


29.S 


A  IIi>li)iy  of  Xursin^Lj^ 


accomplished  1>y  skill  and  dex-ntion.  Ilcr  achicxc- 
ment  was  accented  by  her  <leat]i.  After  three 
years  of  laliour  so  unlirinj^'  and  exactint,'  that  she 
scarcely  had  time  to  write  letters  to  her  fainily. 
she  died  of  typhus  fever  in  the  hospital. 

Froni  her  splendid  deiiiMnstration  in  tlie  Li\Tr- 
pnol  Workhouse  extended  all  the  reforms  in  tlv 
nursin;^'  methods  of  similar  institutions.  I)urin<,r 
her  brief  illness  Miss  Xii2;htin<jale  wrote  toherfam- 
il\-,  "I  look  upon  hers  as  one  of  the  most  valuable 
lu-es  in  l-^n.^land,  in  the  ])resent  state  of  the  poor 
law  and  of  workhouse  nursini,r."  And  after  her 
death  she  wrote  the  exquisite  tribute  to  her  mem- 
ory which  forms  the  preface  to  her  biograj)hy.* 

Another  figure  stands  out  ])rominentlv  amonj^ 
the  ])ioneers  of  that  day  and  followers  of  Miss 
Ni}j;htin^ale  —  Miss  Florence  Lees,  now  Mrs.  Da- 
cre  Craven,  who.se  chief  flistinetion  was  in  im- 
])roving  the  district  nursini,'  ser^•ice.  Althouj,'h 
she  difl  much  more  than  this,  it  is  with  this  that 
her  name  is  especially  associated,  as  Agnes  Jones's 
with  the  workhouses  and  .Mrs.  Wardroper's  with 
the  training  (->f  nurses.  Florence  Lees  was  one  of  the 
first  four  pupils  \\hn  entered  the  Nightingale 
.school.  vShc  has  been  called  the  most  hiuhlv 
trained  nurse  of  her  day,  and  i)robably  was 
so.  After  training  at  vSt.  Thomas's  she  had 
po.st-graduate  courses    in    Berlin,    Dresden,    and 

>  See  Una  and  In  r  Paupers:  Memorials  oj  Agnes  Elizabeth 
Jones,  liy  her  Sister.  First  .\mcncan  frorn  the  second  Eng- 
lish ed.     London,  James  .\isbct  Co  .  iSS; :  \ew  York,  1872. 


Miss  \i;4hiinL,r:ilc's  Co-WOrkcrs    299 


I 


Kaiscrs'  rth;  was  surgical  Sister  in  Kinj,'.s 
Cdllegc  hospital;  tlu'ti  madr  a  I'Uir  of  iii- 
s]»(.'Ctinn  throui,'h  the  hospitals  of  Holland  and 
Denmark.  She  \vas  then  able  to  j^ain  entrance 
for  training'  in  the  Hotel-Dieu,  Larihoisiere.  and 
Enfant  Jesus  hospitals  of  I'aris,  and  later  ser\-ed 
under  the  Sisters  of  Cliarity  of  St.  \'inernl  de  I'au! 
in  two  military  hospitals,  where  she  was  allowed 
to  pass  throu;j;h  every  department,  from  the  kiteh- 
ens  and  linen-rooms  to  the  operatini^  theatre.  In 
the  Franco- Prussian  war  she  had  chan^^e  of  a 
military  hospital  before  Metz.  and  of  the  ambu- 
lance service  supporte<l  by  the  Crown  Princess  of 
Germanv.' 

After  Mr.  Rathbone's  experiment  with  his  first 
district  nurse  his  exam])le  was  c]uite  widelv  imi- 
tated, and  in  London  thr  luisL  Londnn  Soeiet\', 
<irj.;anised  for  the  sole  lienelit  of  the  po.ir,  was 
fiirmed  in  1868. 

In  1874-  the  order  of  St.  John  of  Jerusalem  inaug- 
urated the  National  Xursinj,'  Association  to  jiro- 
vide  more  fully  trained  nunses  for  the  poor,  and 
under  the  ausjiices  of  this  as.sociation  a  very  im- 
portant investij^ation  was  carried  on  under  the  di- 
rection of  Miss  Lees,  who  was  chairman  of  the 
Committee  of  Inquiry.  It  was  found  that  the  whole 
sy:tem  of  district  nursinij;  then  existinjj^  was  ^•c^v 
amateur,   slo\"enl\-,  and    ha])hazard.     The   nurses 

'  See  pp.  xvi-.xvii  Handbook  jor  Hospital  Sisters,  by  Flor- 
oncL'  S.  Lees.  Preface  hy  Henry  .\cland,  M  I)  ,  F  R  S  W. 
Isl)ister Co..  London,  1S74. 

•'  See  Times,  June  23,  June  26,  1S74. 


;oo 


A  History  of  Nursing" 


were  often  almoners  rathrr  than  nurses,  and  the 
connection  with  the  physician  was  \ery  lav.  The 
nurses  often  prcscril  d.  and  boasted  of  "curing 
Wounds  which  no  doctor  had  e^'cr  seen."' 

With  this  n  port  Miss  Lees  made  the  recommcnd- 
atinn  ar.d  cairitHl  tlu'  i)oir,t  wlr'ch  lias  proved  to 
be  of  sucli  c'lnspieuous  l)t>iu'tit  to  the  service  and 
with  which  lu-r  Tiame  must  always  be  associated, 
:7:-.,  that  district  nurses  should  be  entirely  re- 
cruited from  the  class  known  as  }j;cntlewomen. 
It  'vas  at  (irst  rt^L^arded  as  an  unpossibilitv.  Even 
Miss  XiL,'htini,^ale  doubted,  and  said  to  Miss  Lees, 
"1  don"t  believe  you  will  find  it  answer;  but  try 
it— try  it  for  i.  year."  .Miss  Lcfs's  arj^rvu-nents  for 
her  sitle  were  those  which  are  to-day  regarded  a. 
axiomatic,  and  ined  nut  lie  repeated.  She  was 
able  to  carry  thmi  into  jiractiee,  and  the  resubs 
amply  justified  her.  The  a.s.sociation  was  ex- 
tended as  indicated  liy  the  title  .Metropolitan  and 
National  .\ursing  As.S(X"iation,  aiid  .Miss  Lees  be- 
came the  first  superintendeni  ( .f  the  Central  Home. 

To  the  l^nglish  system  of  permanency  of  Sisters 
or  head  nurses  and  of  staff  nurses  (jr  seniors,  which 
was  retained  and  not  discarded  when  the  reform 
of  nursing  took  place,  is  chiefly  dut'  tlie  iiomehke, 
serene,  and  cheerful  atmosphere  so  characteristic 
of  English  hospitals,  whic-li  arc,  in  a  final  cornpari- 

'  See  Mrs.  Dacrc  Craven's  p.ipcron  '  iJistrict  Xursin.i;,"  read 
nt  the  ToiiKrcss  of  Chanties  ami  Correction,  World's  Fair. 
Chic.ifjn,  iS()5  Traitsaclioits  of  Section  on  Hospitals,  Dis- 
pensaries, and  N'ursinj;      p   517 


Miss  NiL;htini;;ilc's  Co-Workers    301 


son,  the  pleasantfst  ami  most  comfortable  for  the 
patients  in  the  worll.  The  Sister  n-maitis  at  thi> 
head  of  her  ward  for  years;  only  leavinjf,  often,  to 
retire  from  service:  the  staff  nurses  or  seniors  also 
remain  for  long  periods,  five,  eijjjht.  ten  years;  the 
]  r-'bationcrs  come  and  5^0,  during  their  three  or 
four  years'  course,  an<l  the  entire  current  is  more 
steady,  more  settled,  less  strenuous,  less  kaleido- 
scopic than  is  possilde  when  an  entire  hospital 
nursing  force  changes  throughout  in  two  or  even 
three  years'  time.^  The  English  matrons,  also, 
have  a  more  ])ermaiient  tenure  of  ofiicc  than  ours; 
their  duties,  p/ivileges,  boundaries,  and  authfirity 
are  more  clearly  recognised,  and  less  fre(iuenth- 
disputed  cr  encroached  upon.  They,  loo,  often 
remain  for  a  working  lifetime  at  the  head  of  their 
households  as  contentedly  as  a  mother  at  thi-  luad 
'  :'  her  famil\'.  It  i--  l:  iie  that  this  security  of  ten- 
ure may  conduce  to  a  narrow  outlook  or  excessive 
conservatism,  but  these  errors  are  avoided  by  con- 
tact with  the  world,  and  exist  as  well  in  our  more 
unstable  en\-in)nment.  Though  changes,  under 
the  English  system,  are  more  slowly  made,  even 
when  desirable,  they  are  more  definitely  settled 
;•;  !  more  gcni-rallv  acquiesced  in  when  once  made. 

'  It  is  common  to  see  in  tlie  English  nursing  press  such  notes 
' ".  these: 

"Miss  Eliza  \Vhitmc:-e,  known  tt>  medical  men  and  nurses 
it  St.  Georj'e's  huspilul  as  Sister  Nannie,'  has  retired  from 
iitue  .vork  after  twenty-live  years  of  devoted  servieu  to  the 


\  presentation 


•ntiy  made  at  the   Norfolk  an- 1 


302 


''.  History  of  Xursing 


The  report  ;ilri.';iil\-  inciitiMiK-iI.  written  fur  the 
British  McJiuil  /('unial  in  1S74,  m  ;  \-  ikiw  he 
turned  to  a,t:;ain  lor  a  j^n'aphic  and  well  toiK'he(l-ur> 
picture  of  the  ire^eral  conditions  of  the  hosjiit  ■  s 
at  that  date,  fourteen  \  ears  after  the  ojunijiL,^  of 
the  Xiuht  iiiL'ale  seli'Hil.  The  eai'her  (  >nditions 
have  bei'n  deseribctl ;  now,  in  1.^74,  ihere  were  the 
St.  John's  House  Sisters  at  Kind's  ("ollL'L,'e  and  at 
Charin^L^  Cross  ;  the  Sisters  of  All  S;iints  at  Uni\'cr- 
sity  Collci^e  hospital,  and  the  XiL,ditin;.j;ale  Sisters 
at '"t.  Thomas's.  At  St.  (ieorye's  and  tlu'  Middle- 
sex the  Sisters,  though  not  ladies,  wert' 1  if  rather  a 
jjetter  social  class  than  the  nurses.  The  oM  plan 
of  havini;  a  permanent  and  rather  iaferior  cda.ss  of 
ni^ht  nurses  was  still  in  force  at  St.  .\ku"y's,  St. 
Gei  'ri^'e's  and  the  Loii.Ii  m. 

St.  Harth' iloniew's  had  IkuI  imtil  r(Tentl^"  the 
(iernian  s\steniiif  ea.h  niu'se  takmi,'  in  turn  one 
ni^'ht  duty  every  tlurd  ni-ht  making  nearly  thirty 
hours  of  continuous  <hit\'.  Tlun  (1874)  each  nurse 
liad  onew-ek  "''  niL'lit  dut\-  alternatinj.j  with  two 
Weeks'  da\'  dut  w 

The  oj.l  pi  III  of  tjivin<,'  Nianl  money  was 
ne.irly  e.xlinct.  It  still  liiij^aTCu  111  a  nioditled  form 
at  St.  Hartholomew's,  where  the  Sisters  had  to 
])ro\i(le  a  great  part  of  tlieir  own  food,  whilst  the 
nurses  riK^eived  uncooked  rations  of  meat,  Hour, 
and  vegetables. 

Xorwith  hospital  of  a  j)iirse  of  liliy-fiM*  soven-iKns  to  Sister 
BiSM'y,  wlio  is  .iliout  to  rotirc  .tftrr  tliirty-i'ijjht  yi'-irs'  sir- 
vicf.  Siu*  i-ntrffil  the  hosiiital  for  truininjj  in  i8ftS  and  was 
api>ointc(l  Sistt-r  in  1875." 


Miss  Xii'htini'alc's  Co-Workers    303 


The  special  c 


oinniissii  iiKT  s 


aiiv  nurse 


as 


]:)eaks  ot  tlie  (jui'stiou 
1 1  ivallv 


)unii!r'     (Jiie, 


iiKaiU  an  entire  reorijjanisalii in  of  hospital  \vork, 
ainl  some  hospital  ilircelors  Wiiv  nmeh  ojipnsed 
t'l  "lady  nurses,"  lnvanse  of  the  nt.'eessit\'  it  in- 
'  'il  ot  a  srjiarate  stall  lor  ro-ii^dt  housework. 
1-  '.,,is  hard  for  some  mm  to  hrar  that  the  nurse 
ir.usL  eease  la'iiit,^  a  seruhhi'r:  hut  others  pointed 
and   uiiplrasant  natun^  of  many 


u-it  the  diflieult 
|iiirelv  luirsini,'  (hities  and  insisted  1  )n  tlie  absurdity 
:,;kin;^^  up  the  tinu-  ot  trained  ])rrsons  to  do  un- 
skilled lahoui-,  makiuL^r  it  eU'ar  that  the  (hx'ision 
(if  labour  ])roposed  did  not  mean  that  seruJibinij 
was  (k';>iradinj^  or  nuiiial,  but  that  the  nurse  should 
he  free  to  nurse,  and  not  br  takrn  a\\a\'  from  the 


patient  to  serul 


i..,i 


A  u'i'eat  impro\rmcnt  was  re- 
in the  j^^eiieral  awrai^^e  of  (.'dueatiou  aniotii^f 
nurses.  Thus  in  iSd;  in  a  IaV'^v  pro\  ineial  hos- 
pital seven  out  o!  twruty  mirsrs  eould  not  read  or 


write,  an 


1  th 


rce  ot  thrsc  WTi' 


e  Ueail  nurses. 


But 


in  1.S74 no  hospital  'aouM  aeet'jit  nurses  unle.ss  they 
aid  read   and   write.      Tln're  was   a   disliiu't  im- 

jirovcment  in  the  i|ual!t\'  of  woman  aj)plvin^'.  and 

in  the  niajont\'  of  Londo!i   JKisjiitals  the  Sisters 

wcTi'  ladies. 
TIk'  improvement  adwmeed  but  slo\vl\-,  writes 

.M;s.  Strong: 

In  the  Glaspow  infirmary  at  the  be^innins  of  the 
last  ([uartcr  centur>'  (about  1870)  a  nurse  had  to  bc^in 
as  a  semi-wanhnaiil  under  tin-  natne  of  assistant  nurse 
and   work    her   wav    wilhouf    .in/   direct    instruction. 


304 


A  History  of  Nursing 


She  was  called  at  3  a.m.,  and  bepan  work  at  4,  clean- 
ing grates,  scullery,  and  bath-room,  sweeping  and  du.st- 
ing  the  ward,  etc.  She  also  carried  the  food  for  the 
ward  sup5)ly,  washed  the  dishes,  and  did  much  heavy 
carrving  which  is  now  dune  by  men.  Her  duties 
ended  at  8.30  p.m.,  witlvjut  any  definite  time  off  duty. 
Most  of  t!ie  women  slept  in  small  rooms  adjoining  the 
wards  and  t'H.k  their  meals,  with  the  exception  of 
dinner,  in  the  ward  kitchens.  Nurses  and  servants 
shared  the  same  dining-room  and  had  to  carry  a  knife, 
furk,  and  glass  with  them.^ 

The  (Iclilicratio!!  \vilh  which  the  Enghsh  hos- 
]ntals  acluiHcd  the  new  order  i.s  shown  in  a  ddight- 
fully  gossipy  reminiscence  of  one  of  the  Sisters  of 
the  first  cla.ss  of  probatinixTs  a^,  St.  Bartholo- 
mew's hospital  (which  later  rapidly  moved  to  the 
verv  front  of  pmgjrcss  on  i)ractica],  social,  and 
educational  lines)  when  the  change  was  instituted 
tht-re : 

A  Reformatio)!. —  ...  I  came  in  on  May  i,  1S77. 
ju^t  live  and  twenty  years  ago.  I  was  une  of  a  batch 
of  twelve  probationers,  the  first  to  be  trained  at  St. 
Bartholomew's  hospital.  Before  we  came  there  was 
no  sort  of  training  for  the  nurses,  and  of  nursing  as 
one  understands  it  n^'W  there  was  simpily  none.  The 
matron,  Mrs.  Drake,  greatly  disapi)roved  of  such  an 
innovation  as  "  lady  nurses,"  and  tried  hard  to  dissuade 
tne  from  entering  when  I  came  up  t')  be  interviewed. 
There  was  no  entrance  examination.  Wi  all  arrived 
one  morning  and  proceeded  to  jiut  on  our  \iniforn-. 

'"Preliminary  Work,"  by  Mrs.  Slrotij;.  International 
Congress  of  .Nurses,  UutTalo,  igoi.     Transactions. 


f  =  ^ 


■^  -  •< 


in 


Miss  Niehtincfale's  Co-Workers    305 


j^o 


What  was  it?  The  present  probationer's  uniform, 
with  the  exception  of  the  caps,  which  were  small  caps 
without  string's.  This  was  quite  different  from  the  uni- 
form of  the  so-called  "staff-nurses,"  wIki  wore  brown 
merino  dresses,  aprons  without  bibs,  collars,  no  cutis, 
ca;>s  or  no  ca[>s  as  they  liked,  and,  when  worn,  of  any 
description.  I  remember  hearing  some  weeks  after 
v.c  arrived  tliat  the  head  dispenser  had  pronounced 
us  "an  ornament  to  the  square." 

In  the  afternoon  we  attended  a  lecture  by  Sir  Dyce 
(then  Dr.)  Duckworth  in  the  lecture-theatre.  Though 
especially  for  Dur  benefit,  it  was  an  open  lecture.  A 
few  of  the  Sisters  and  statY  nurses  were  there,  and 
many  students.  .  .  .  Curit^sity  bniui,dit  them,  I  sup- 
pose. We  were  something  quite  new  ami  caused  a 
considerable  slir  in  ilie  [dace. 

That  night  I  was  sent  to  "Harley,"  where  I  shared 
a  room  opening  into  the  ward  (the  "dressing-room") 
with  the  staff  nurses.  I  did  not  get  much  rest.  To 
beijin  with,  my  roommate  was  very  drunk  and  very 
sick.  Being  ignorant  of  the  symptoms  I  wasted  much 
pity  on  her.  When  I  did  fall  ofT  to  sleep,  I  was  awak- 
ened by  frightful  screams  and  shouts  of  ".Murder! 
Fire'"  I  proceeded  to  wake  my  companion,  who 
growled,  "Be  quiet:  it's  only  iS."  Drunkenness  was 
very  common  among  the  staff  nurses,  who  were  chiefly 
Women  of  the  charwoman  type,  frequently  of  bad 
character,  with  little  or  no  education,  and  few  of  them 
with  even  an  elementary  knowledge  of  nursing.  Some 
of  them  might  have  worked  previously  at  some  other 

^pital,  but  as  often  as  not  they  had  had  no  experi- 
ence whatever  when  engage<l  as  staff  nurses.  One 
Woman,  I  remember,  who  came  some  little  time  aftt-r 
i    did    and    under    wlmm    T     worked,    liad    been    a 


'^ 


;o6 


A  History  of  Xursini^ 


ladv's-maid,  and  !iad  never  done  a  day's  niirsing. 
She  was,  howeNer,  nf  a  tlecidedly  superior  class  to  any 
of  the  others,  and  was,  moreover,  quite  respectable. 
It  was  vtr\- usual  tor  the  tVicnds  to  l.rin.i,'  in  jiresents 
of  ;,'in  to  l)ribe  the  nurses  to  be  kind  to  the  piatients. 
The  worst  women  wc  had  were  those  who  used  to 
come  in  to  look  after  bad  last'S,  more  particularly  at 
nii^ht.  Thcv  Were  I  alKd  "  ni^lit  e.\tras."  They  were 
most  dreadful  jjcrsons.  posscssint,'  neither  character 
nor  ability,  who  used  to  ajijily  here  for  work  much  as 
Women  now  apply  for  charin.^.  I  nnicmbcr  bein,!,^ 
so  horrified  soim  after  I  came  at  the  idea  ot  a  \ery 
bad  case  (a  man  wh' 'se  le.i,'  was  amjaitati'd  at  the 
thij,dii  bein.L;  left  to  the  tender  mercies  of  one  of  these 
iTcaturcs.  that  I  summoiieil  up  couraL;c  to  :isk  Sister 
Ilarlcv  to  put  nic  on  as  "sjjecial"  instead.  She  con- 
sented, and  I  looked  after  him  in  tlie  daytime;  at 
nij,dit.  of  curse,  he  h.ad  the  "lydy  "  from  outside. 

Amon^'  ihe  Sisters  thi-re  was  ahvady  some  impro\e- 
mmt.  Si -me  tluTc  still  were  of  whose  virtues  the  less 
said  the  better,  and  some  were  wholly  untrained,  a 
knowled.ire  of  mn^sin.L;  not  bcini;  m  iliose  (i;i\s  a  neces- 
sarv  quali!icali"n  for  a  Sister.  Sister  I'ilcairn,  how- 
e\-er,  had  been  i^r  a  \ear  or  two  in  I'itc'iirn,  and  was 
undoubtedly  much  the  most  highly  naiued  nurse  then 
in  the  li"<i'ital.  and  Sister  Kyes  was  the  ni)hthalniic 
Sister,  tlic  tirst  to  be  api'oinic'd  for  that  special  work. 
.\  few,  also,  ha<l  been  trained  in  the  Xi,t,ditin<;ule 
Home.  \Vc  should  not  think  much  now  of  the  train- 
ini;  thev  had  had,  r)ut  it  was  a  p^ood  deal  for  that  time. 
Thev  al>o  had  had  considerable  e.\])ericnce,  and  were, 
moreover,  clever  .and  capalile  wonn'U  I'f  superiur 
character. 


How  were  we  tauLdit?     W 


)\   the  Sisters  very 


Miss  \iL;htin^ra!c"s  Cu-\\'orkcr^ 


;.o: 


little.  (The  stafT  nurses  were  not  capal.ilc  of  tiarliiiiLr 
anything,'.)  l"cv.'  of  the  vSisters  both  couM  ami  wouM 
teach  lis.  I  do  nr)t  think  any  Sister  tauj^'ht  nie  anv- 
tliint,'  except  Sister  Mattlnw  (as  she  was  then)  aivl 
Sister  I'itcairn.  Sir  Dvi  i;  Dm  kworth  or  Mr.  Willctt 
lectured  t(j  us  >  r  ,i:^a\e  a  practical  demonstration  once 
a  week.  .Mr.  Willetl  used  to  have  in  his  f)Ut-i)atient 
children  and  ti  ach  us  to  bandafre.  put  on  splints,  to 
make  and  apply  plasters,  bandaires,  atid  so  on.  Sir 
Dvce  would  take  us  into  the  wards  an^l  ,L:i\e  us  a  lesson 
un  bed-makint,^  poultice-makin,ir,  ()r  on  tlie  contents 
of  the  doctor's  cupboard,  or  down  to  the  batii-rooms, 
where  he  and  'i]d  Williams,  the  bathman,  used  to 
sh'iw  us  the  best  way  to  j,^et  patients  in  and  out  of  the 
hath,  and  how  to  ]irepare  special  baths  of  various 
kinds.  We  were  kncnvn  as  "Ducky's  lambs."  .  .  . 
The  present  bath-rcjoms  oil  the  wards  were  only  just 
bcinc;  built.  Before  we  had  them  all  patients  who 
were  in  tit  condition  were  bathed  in  the  baths  under 
th.c  out-patient  department.  The  (,nl_\'  baths  in  the 
wanls  were  in  th.c  kitchens,  and  were  covereil  over 
witli  woo<len  covers,  which  often  served  as  a  table  on 
which  to  carve  the  dinners. 

Then,  we  ])icked  up  what  we  could,  and  the  resi- 
dent staff  and  students  tau.irht  us  a  t^^oocl  dial.  .  .  . 
We  were  quite  a  novelty,  and  e\-ery  one  took  a  j^reat 
interest  in  us.  Dr.  Orithth.  I  think,  tati,i;ht  nie  to 
take  tcmjieratures.  lie  was  a  dress(  r.  The  ther- 
mnmeters  in  use  tlien  were  ver\'  much  lonL:er  than 
those  we  use  ncjw,  and  had  to  be  read  while  in  posi- 
tion, as  they  ran  down  at  once  when  removed  from 
ihe  mouth  or  armj)it.  Tliey  cost  twelve  .shillin.i,'S 
si.\pence  each.  The  Sisters  and  nurses  never  used 
a  thermometer,  the  dressers  and  ilcrks  took  the  tern- 


;oS 


A  History  of  Nursinir 


peratures  when  required.  W'c  prclirtioncrs  were  ex- 
pected to  learn  tlie  use  nt'  the  eiuucal  thermometer, 
but  there  was  generally  a  row  if  a  Sister  caught  us 
with  one. 

To  show  ynu  how  little  we  were  shown  our  work, 
I  must  tell  yiiu  two  things  I  remember  having  to  do 
witliin  my  first  month.  One  day  a  sweep  was  brought 
into  Ilarlcy  straight  from  his  wofk  with  si.\  fractured 
ribs.  "  Pro,"  said  Sister,  "go  and  wash  that  patient." 
I  had  never  been  shown  how  to  set  about  such  a  task, 
and  his  hair  alone,  which  was  full  of  soot,  nearly  drove 
me  til  despair.  Aimtherday  I  was  orderc'il  togi\-e  soap- 
and-water  injections  to  the  same  man,  and  also  to  a 
man  v.ith  a  very  bad  compound  fracture  of  the 
femur.  I  had  never  given  one  before,  and  h,ad  nu 
instructions  whatever  given  to  me.  I  knov,'  I  was  in 
tears  before  I  had  finisheil,  and  so,  I  f(.ar,  v.-ere  the 
patients.  We  had  always  to  tind  out  things  for 
ourselves. 

"  IIcjw  did  We  get  on  with  the  statt  nurses"  On  the 
whole,  very  well.  You  see,  our  coming  brought  about 
several  improvements.  To  begin  with,  before  then 
all  the  three  nurses  (night  and  day)  shared  the  one 
small  bedroom,  sleeping  '"Box  and  Co.x."  When  we 
came  the  "night  home  "  v.as  arranged  to  accommodate 
the  night  nurses,  which  left  only  the  two  day  nurses 
to  sleep  in  the  ward  bedroom.  Then  a  dining-room 
was  also  made  (part  of  our  jireseiit  library),  where 
breakfast  and  dinner  were  provided.  Tea  we  had  in 
the  ward  (not  in  the  kitchen),  and  for  supper  we  had 
only  what  we  chose  to  get  for  ourselves  before  going 
to  bed.  Before  we  came  all  the  nurses'  food  was 
c(joked  and  eaten  in  the  wards,  as  also  the  Sisters'. 
The  Sisters  had  no  dinner  provided.     They  were  given 


Miss  Nightingale's  Co-\Vorkcrs    309 

a  chop  (unconkod)  on  Sunrlays  only.  They  lived 
entirclv  in  +hcir  rooms,  which  were  half  the  size  mf)st 
(if  them  are  now. 

What  hours?  We  were  on  duty  from  7  a.m.,  until 
ij  i'..M.  Twice  a  week  we  were  sup[)(jscd  to  ^'o  otT 
(lutv  for  two  liours,  6  to  8  p.m.,  and  to  have  a  half- 
day  (3  to  9)  once  a  fortni.Ljht.  I  say  "  sii]>posed,"  as 
we  never  i^ot  off  punctually:  the  work  could  not  be 
finished  in  time.  "When  we  came  in  wc  went  on  duty 
asjain  until  ten  t/chjck. 


Of  course,  nursin<:j  as  you  understand  it  now  was 
utterly  unknown.  Patients  were  not  "nursed"  then; 
they  were  "attended  to,"  more  or  less,  but  there  was 
only  one  nurse  <in  each  side  of  tlie  ward,  and  the  work 
v.'as  very  hard  —lockers,  locker-l)oards,  and  tables,  of 
course,  to  scrub  every  day.  Wc  did  not,  as  a  rule, 
scrub  the  floors,  though  I  have  scrubbed  the  whole  of 
the  front  ward  of  Matthew  (Faith)  c)n  a  special  occa- 
sion before  6  .\.m.  I^uke  was  the  only  ward  where 
the  floor  was  scrubbed  daily,  each  nurse  doing  her 
half,  and  Sister  herself  lending  a  hand  if  thev  were 
very  busy.  (I^uke  was  considered  a  particularly 
smart  ward  in  tliosc  days,  and  Sister  alwavs  wore  a 
black  silk  dress  wlicn  she  went  roimd  with  the  visiting 
jihysician  I  i"he  patients  had  their  beds  made  once 
a  day,  the  bad  cases  had  their  sheets  drawn  at  night. 
In  Mattluw  all  of  the  patients  gc)t  out  nf  bed  everv 
day,  even  the  typhoids — it  was  considered  rather 
smart.  Then  one  thought  nothing  of  having  fourteen 
r  liUcen  poultices  to  change.  All  wounds,  of  course, 
■ippurated,  and  required  dressing  or  povijticing  twice 
cir  three  times  a  dav.      I  well  n>mcmber  Mr.  Willett 


nn 


,iO 


A  History  of  Xursin 


sjiyin.i,',  wlu-n  UouriTis^'  m  iis  on  wnunils,  "Thorc  are 
three  modes  of  liealin.s,':  the  lirst,  most  to  be  desired 
Vut  never  seen,  by  first  intentifm;  the  second  by 
<,'ranulation;  aiv!  the  third,  which  is  always  seen,  by 
sui)])uration." 

What  was  f.'Ur  life  in  the  liome  Hke?  There  was 
noiliin,-,'  of  tlie  sort.  We  had  breakfast  and  dinner 
in  the  home;  otherwise,  when  off  liut}-.  if  v/e  (hd  not 
troout.  we  sal  in  tlic  w;ird  kitrliens  or  in  our  bednM)nis. 
The  food  was  fairly  ^^ood.  There  was  no  (.ne  to  o\-er- 
look  our  behaviour  or  to  see  th.at  we  went  to  bed  at 
the  riirht  time,  or  anythin.L,^  of  that  sort.  Indeed,  I 
often  sat  u]<  vvrv  late,  and  when  in  I'.aith  wtiit  round 
frequently  with  Sister  .-md  the  liouse  physician  when 
they  made  the  !iiL,dit  round.  1  learned  a  trood  deal 
then.  I  ^cnrrally  liad  to  write  my  h  (  ttn-es  out  before 
I  ii<)t  up  in  tlu:  morning',  I)(.iween  h\i-  and  si.K.  It  was 
the  only  quiet  time  and  the  only  time  of  the  dav  wlun 
my  h.cfiil  was  clear  enough :  at  nii^ht  I   was  too  tired. 

At  the  end  of  the  \-ear  wc  jiassed  an  e.xamin.-ition 
held  murli  on  tlie  <ame  lines  ;is  now.  but  I  belie\-e  that 
marks  were  not  awarded  by  the  matron  until  after 
Miss  Manson  came  (.Mrs.  Bedford- Fenwickt.  AVe 
were  awarded  certificates  and  offered  posts  as  staff 
nurses,  which  few  were  bold  enom,di  to  accept  (.n 
account  of  the  existmj,'  condition  of  thin,!.,'-s. 

We  objected  to  assoriatin.t,'  constantly  and  sharing 
rooms  wiai  the  staff  nurses,  to  chari^dnL,'  our  clean 
cotton  uniforms  for  their  bnnvn  stufY  dresses,  and  to 
carryinjj  the  soiled  linen  from  the  wards  to  the  laundry 
(which  the  stall  nurses  had  then  to  do),  and  various 
other  things.  The  treasurer  promised  to  try  an.d  alter 
these  things,  and  did  b\-  degrees. 

Things  improved   little  by  little.      One  or  two  out 


]\Iiss  Xii^htingalc's  Co-W'orkcrs    311 


if  cvcrv  batch  of  pnibatinners   ftlTcy  came  iti  vwvy 


tliri't 
ti'in. 


niDnths)  stavfil  im  after  iiassiri'^  the  exaini 


na- 


Then    Mi-^s    Mach 


who    tjccaiue    matron    in 


1879,  mcreasfil  the  oeri'nl  oi  trainin'^^  to  two  years,  si 
that  we  had  a  certain  niniiber  of  si.'ennil-year  nurse> 


n  w 


horn  we  couhl   (U] 


end 


It   was  not, 


iiowe\-er, 


until  after  Mrs.  Bedford- i'enwii  k,  then  Miss  Manson. 
eame  in  1881  that  tlie  old  .untrained  .Sisters  and  nurses 
re<,Tadually  weeded  out  and  the  training  lengthened 


Wi 


t"  three  years. 

A  treniend'ius  change?  Yes,  greater  than  you 
ran  imagine.  I  lia\-e  really  no  words  in  which  to  de- 
scrihe  the  stat(>  tlie  li'ispital  was  in  when  I  .  ime  as 
I'Viihationer,  and  if  T  had.  y  ^u  wnuld  sa\'  the  accoimt 


was 


not  fit  for  jiul'licali'  >n. 


W 


;en  fir- 


became  Sis- 


ter I  often  stayed  u\>  all  night  because  there  was  no 
one  to  look  after  my  jiaticnts  but  an  old  wnman  |iriib- 
ablvliiith  dnud<  and  disrepinable.  and  imable  either 
tnrcatl  or  write. 


was  manv  years 


bi-r 


ore  the  riiu"suii 


dl'i  in  <ren- 


cral 


rcsiicct 


was     trcatei 
1 


wit  I 


anythuig     apjjroachini 


'Sister    "Casualty,"    in    "  I,r;i'_r!R'    Xc.vs."    Journal   of  St . 
Piirtiiolomcw's    Xiirscs'    Lc.if;}tc,   No.  5,    .May,    1902.    ]'.     1  54 


CHAPTER  VI r. 


THR  TRKATV  OF  [-.ESV.WX   AM)  THi:  RED  CROSS. 


IX  rradiiii;  (if  w;:!-  mirsiiii;  aii'l  the  rclirf  of  the 
wmuikK'i!  to-tlny,  the  activity  of  the  Red 
Cross  wnuM  Iootii  larm"  o]^  cwry  pai^^o,  mitii^ralinjj 
and  repairini;  th-  li<  Tmrs  an. I  brutalities  of  battle 
beUw'cn  jiiaii  aii'l  h's  fellows;  but  no  such  bcneti- 
I't'iit  ai^i'uey  existed  at  the  time  of  the  Crimean 
War.  Th-s  was  one  of  ilie  last  ^nat  wars  to  1 
carried  on  before  a  lyeneral  humanity  orLjaniseu 
its  counter-, ,nn\  ot  relief.  Miss  Xii^htinirale  aivl 
her  aides  had  to  eo\-er  as  1  lest  tlii'\-  nii.^ht  the 
\\liok'  _t,n-ound  iio'.s-  e,i;-eil  for  b\-  a  iiiL;hly  ?;\-stema- 
ti"^ed  network  of  medical,  surj^ieal,  tiursiuL:.  ami 
^,  neral  relief  service. 

In  whose  mind  had  the  thou-ht  of  neutrality 
f  ir  the  woiuided  irstarisen?  Who  shall  say  how 
far  baek  i  had  been  j^emiinatinij?  There  was  Ifal- 
dora,  ot  Iceland,  who  lived  al"  'ut  th.(>vear  looo — "a 
fair  woman,  ■  nd  .she  had  a  j^ood  teni|ier";  she  was 
also  a  woman  of  ^Teat  intellectual  faculty,  and 
shi'  had  "a  lovely  mind."  After  a  deadly  battle, 
Haldora  had  said  t'>  the  wonun  of  lu-r  house,  "Let 
UL  go  and  dress  tlie  woutuls  of  the  warriors,  he 

:,ia 


Treaty  of  Geneva  antl  Ri:<l  Cross      313 


tliey  friends  or  foes."  She  herself  sf>ui,4it  th( 
wounded  in  ever_\-  direetion,  and  came  upon  tiie 
ih:i1t;iin  of  tlie  tneni\-,  piostrate  with  a  ,L;hastlv 
wuui.il  (if  the  ehest  thiv  mj^^h  which  Ins  hm.L^s  cnuld 
!ic  Seen.  Il,ild(ira  ihvsseil  the  wnund,  stayed  1)\- 
hi:ii  all  da\\  nursed  him  assiduously  and  he  liv 


e(! 


iii'j 


ns    hie    to    her 


Th 


IS 


.\1'-^  X 


I  irne, 

,1 


Si  line  ^■(,■ars  lieti  ire  the 


ppene 

|ie(  iple  o 


a_\-s 
f  the 


North  ;(d.(i]ited  ( 'hristianity,  and  it  was  not  until 
iS6^  that  the  treat\-   of  (leiiewi  .>aw  the  liffht."' 


Ai,'ain, 


in  the  war  of  iSi  .;,  three-  women  of  Frank- 


furt had  issueil  a  call  which  brou<,dit  to.^ether  all 
the  Women  ot  the  city  in  .1  un.ioii  to  pro\-ide  care 
for  the  W(.)unded  without  (hstinetion  between 
friends  and  enemies.  This  "  Frauenwrein  "  ;intic- 
ipated  the  sj)irit  of  the  '"ed  Cn  iss. 

M.  Moynier  in.stanci.  >  the  \\-ork  of  the  Knights 
li   -pitallers  ,cs  a  sort  ot'  R^'d  Cross  work,  and  men- 

•  ^  the  creation  of  ;i  medieal  service  attat'hed  to 
armies  as  having  been  rcj^'arded.  through  the  past 
three  centuries,  as  all  that  could  be  rerjuired  lor 
t!ie  emerjjencies  of  war.' 

The  orijfin  of  modern  arnu'  medical  service  is 
ascribed  to  Is.abella.  (jueon  of  Spain,  who  in  the 
wars  of  her  time  founded  tint  hospitals  for  the 
soldiers  and  supplied  them  with  medicines,  a];pli- 
.ir:(  rs,  antl  attendants  to  a.ssist  the  physicians. 

\ursjng    in    Denmark,"   by  Charlotte   Gordon    Norrio, 
Krruan  Journal  of  Xursi-     i3ec.,  1900,  pp.  183    184. 
'  7/V  Red  Cross:  Its  Pa     .<td  its  I'utnre,  by  Gustav  Moy- 
1.  President  of  the  International   R>.1   (V. .';■;  C.Mmnittce. 
tulfin,  Paris,  New  York,  1883,  p.  i  j 


314 


A  History  of  Xiirsing 


UiUil  ilic  liiiir  of  Mi.ss  .\i;^litinL,^ili's  ownhniw 
(if  arni\'  IraditiMUs  snLit-ty  la.l  rrstrl  satislirtl  in 
thf  liflii'f  ibat  111!  ]\u>w  vrnxhl  lie  iloiK-  for  the 
soMirr  in  tiiiK'  of  war.' 

The  niodrni  ors^anisatioii  known  as  ilw  Rvd 
Cross  owes  Us  inrrption  to  1  Irnri  D'lnanl,  a  Swiss 
VH-nlk'inan  who,  v  hilc  IrawIlinL;  in  Ital\-  in  1859, 
x'isiU'il  i!ir  !Mtllr-!iiil  after  tlie  lil'  lody  ila>-  of  Sol- 
firino.  \(Mii\  fo:-t\-  thousanil  nun  hail  keen  lost 
in  tliis  kattk,  anil  the  w  lan-le'i  were  wiik'ly  distrib- 
nled  o\-er  an  ixlensi\e  lei^ion.  So  inadeciuate  was 
I  lie  nlief.  a'thouLzh  the  inliakitants  c  )f  nei,L,'hk()ur- 
in;4  1'  'wns  did  all  m  iht  ir  ])i  >\\rr,  th.:t  the  wmmded 
and,  ilrad  ahk^'  !a\"  on  the  ijronnd  tor  da\s  tin- 
tended,  and  nian\'  vlio  niij^dit  ha\e  l)een  sax'ed 
(lied  of  ne,^leet.  The  seeih  s  of  iU(  dle^S  SUlTcrill,!,' 
niad(_'  so  (k'ep  an  iin]iression  on  I  )nn,iT!t .  who  joined 
as  a  \'ohniteer  in  the  nulanehoK  task  ot  attetnpt- 
in,i:  t'  >  sneeour  a  I'ew  at  k'ast  of  the  wi  atnded,  that 
a  little  latir  he  wrote  ;i  (leseri])tion  of  ..d  that  he 
liad  seen,  tinder  the  title. 1  Smcruir  of  Solfcriuo. 
in  a  panijihlet  that  eivated  a  prol'otind  and  jfcneral 
im])r(."Ssion.  In  it  ho  stronjijly  advocated  the  or- 
j,janisation  of  .some  sullicient  way  of  caring'  for  the 
wonnd(  d  after  battle,  and  he  followeil  11])  the  im- 
])r(.'Ssion  his  pnblieation  had  nia(k'  by  k'Cturinj,', 
and  brinj,;in,i,'  the  stibieet  in  ever)-  wa\  b(.'toro  the 
public  coii.scietici'.      In  licneva  he  secured  the  siip- 

1  Al  a  meeting  of  tho  Ko.l  I'ross  stxit-tios  of  the  world  held 
in  L(jnili)n  in  June,  I'jo;,  utianinious  ri'siilutidiis  were  passed 
lioiiDurinn  Miss  .\i>;ht inhale  and  di'cl.innjj  that  her  work  was 
the  l>ej;innin>{  of  the  Red  Cross  aetivilies. 


Treaty  of  Gcnc\a  and  Rctl  Cro.^;;      31 


]y,rl  lit"  M.  t'ii!sta\-  Mnynicr,  the  pri'siilciit  <>{  the 
S(icift\'  ut  I'uliHi'  I'lilily  ami  a  (.-iti/.cii  >  i{  rare 
(lualitics,  who  callct]  thr  soe-irty  luL^cther  tn  ci in- 
sider "a  ]iri  i]i(isili(in  relaliw  to  the'  fcinnaliun  of 
pennain'iil  .si  .rieties  fur  llie  rclici  ni  wounded  sol- 
diers." On  tile  ()lh  of  !'\d)ruar\',  iS():;,  Dunaiit 
apjA'art'd  luiorc  the  SoL-icty  1  if  j'ulilic  Utilit\'. 
and  sel  t'oi-th  ins  ]i]an.  whirli  was,  in  lirief,  to  have 
er^anised  in  i.'aeh  eounlr\'  euilral  association.s 
whieh  should  he  responsihle  fur  the  adininistra- 
tiiiii  of  relu  t'  in  \\ar,  .and  wineh,  while  inih'iirndcnt 
nf  eaeh  0I h,  r,  shi 'rd'!  eaeh  he  tormed  undi-r  the 
pnitoctinn  of  its  own  eoiiutry's  laws,  all  liein<_j 
a!iiliatt.'d  together  in  an  ii;ternati' m.il  voluntary 
hiiiid.  The  ]ilan  uk  {  witli  the  \\-arnirst  sujiport 
I-:  the  hearers,  who  wcr'  nieii  npri^entin^  the 
highest  and  finest  t\|)es  of  eixilisation,  and  the 
Society  of  I'uMie  I'tditN"  took  aeiinn  1)\-  appoint- 
iuLj  a  comnnltee  to  takr  the  jM'iprr  steps  tiA.ard 
<)r;,;anisation.  As  thr  outeome  of  th^'  d(,in_L,^s  of 
this  committee,  an  international  eoin^Te.ss  was 
ealk'fl  to  meet  in  (ienewi  in  ()etMlirr,  iSfi^,  to  con- 
sider how  the  hiin-iii-s  I  if  wai"  naeht  he  lessened 
f(ir  the  Wounded  and  the  siek.  The  oiiieial  repre- 
sentatives of  fourteen  nations  attiiided  the  e()n- 
j,'ress,  which  was  in  session  for  four  days.  There 
Were  also  ])rest'nt  the  rtpnsrnt.it ives  of  benevo- 
lent associations,  notably  the  order  of  St.  f  dm  nf 
Jerusalem.  All  the  chief  nations  of  Europe,  ex- 
(-■e|)t  Russia,  si'ut  delegates,  but  the  United  States, 
then  distracted  with  its  own  ei\i]  w.ir,  made  no 


3i() 


A  History  of  Nursing 


response  to  the  call.  It  was  ac^^ree'l  bv  the  dele- 
gates that  a  Seconal  eoiif'Teiiee  shcuM  take  place 
in  Cienewi  in  the  lU'Xt  \ear,  1864.  and  that  a  lornial 
agreement  or  treat)  should  then  !)e  presented, 
providing  for  the  neutrality  of  hospitals  on  the 
fields  of  battle.  .\t  this  second  meeting  the 
famous  articles  known  as  the  (imeva  conx'cn- 
tiiin  I  ir  treaty  were  adapted;  they  are  nine  in 
all,  but  a  section  of  the  last,  referring  onh'  to 
the  details  of  proci'dure,  is  sometimes  printed  as 
a  tenth.'  They  provided  for  the  neutrality  of  all 
ambulanct.'s  and  Iv  )spitals  and  their  su])plies,  ef[uip- 
ment,  and  j)rrsonnel,  and  adiopted  a  tlag,  badge, 
and  uniform  to  distinguish  and  ])rotect  them.  The 
insignia  agreed  upon  for  the  mv/  ^dcidv  was  a 
modification  uf  the  Swiss  Cdlours,  which  slv  >w  a 
white  cross  on  a  red  held.  It  was  decid.ed  to  re- 
\erse  th'.'  colovirs,  and  thus  the  red  cross  on. 
a  white  ground,  '•>  br  placed  conspicuously  on 
ambulances,  e(iuipnient s,  and  accoutrements  of 
hospital  service,  and  to  be  worn  upon  the  arm  nf 
aides, — till'  hr:t<s\!rJ, — was  adoptei!  as  the  badi^'e 
oi  tlu'  soci(.'t\-,  which  was  henceforth  to  lie  k'lown 
in  everv  countr\-  as  the  "  Red  Cross."  It  is  inter- 
esting to  -ecall  here  that  many  centuries  ago  the 
Knights  of  St.  John  of  jemsalem  in  carrying  on 
a  work  of  similar  purjwsc  atlopled   the  Siime  in- 

'  Their  full  ti'xt  is  giviti  in  tho  History  oj  the  Red  Cross, 
the  Treaty  of  Genci>a,  and  its  Adoption  by  thf  United  States 
(pulilishcd  by  the  American  AFsociation  of  tne  Ked  Cross; 
printed  by  the  Government  Printing  Ollice,  i88jj,  pp.Si-S3» 
and  in  Moynicr,  of.  cit  .pp.  lyy-iyg. 


'I  rc.itv  o\  ("icncxci  ami  RcJ  Cross      317 


sit^nia  and  were  known  as  ■  Kni.^lilh  ^  f  ihe  Red 
Cross." 

I-'ree  and  liberal  Switzerland  is  the  onlv  countrv 
mti'rnationally  organised,  and  is  the  lu'ad  and 
centre  of  international  R(Mi  Cross  relations.  Its 
standini^'  eoniinittee,  of  whieh  M.  Mo\-nier  became 
president,  is  a  elearin^dii  mse  for  Reil  Cross  work 
all  over  the  world.  Tlie  eonimiltee  stiinulat(-d 
organisation  in  countries  not  vv\  in  the  bond,  dis- 
seminated information,  promott-d  research  for  the 
improvement  of  methods  and  equipment,  and  in 
general  ,i,nnded  the  whole  n^'twork  of  afliliation. 
.■^•.v:t7.erland  ,ind  l-'rance  were  the  lirst  nations  to 
..r^n  the  treats  ;  others  held  back  a  little  at  tirst. 
hut  soon  ten  others  sii^ned,  and  a  little  later  all  of 
those  present.  So  ureat  wa.s  the  -[xipular  a])])ro\aI 
that,  at  the  time  when  (^nl\-  tiii  sii,Miatures  ha^l 
been  affixed  to  the  tri'at\-,  there  were  alrtad\- 
twenty-five  central  committees  orjjanised  in  as 
many  countries.' 

The  four  leadin.i:;  principles  on  which  the  foinid- 
■  ■>  of  the  (icnexa  treat^■  leased    their  jilans  were, 

■  has  been  w.ll  I'xplaiiU'd    !  \-  .Miss  Clara  Barton 
:"r  many  years  the  president  of  the  American 

.■society)  —  1.  Centralisation:  Eflicienc}'  of  relief 
in  time  of  war  depends  on  unity  of  direction; 
therefore  each  country  must  have  its  central  com- 
•  ^;-^lon  or  liody.  Preparation:  To  be  ready 

■  The  countries  that  first  signed  were  Italy,  Radon,  Hcl- 
Kuini.  Penniark.  Holland,  Spain.  Portugal.  France.  Prussia, 
S.i-.onv,  Wurtcnilmrg.and  Switzerland 


'^ 


,iS 


A  History  of  Nur>in''' 


for  scrvicr  iti  war  or  i  )t!K'r  calamity  incessant  prcp- 
arati'iH  must  lie  (.'ajTiiil  (in  \\\  times  <>\  ])cacc.  3. 
lm]iartiaiil\' :  Xatii'iial  socii'tics  arc  nut  always 
in  a  ji'isitiiin  Im  reach  ih('ir(i\\'n  soMu'rs;  therefore 
all  M  icu'tics  must  d  |ualh'  1  n.'  reai  1\'  t<  >  rescue  triemls 
or  foes.  4.  Sdli'larity :  Xeutral  nati'>!is  must  be 
enal)le<!,  thniU'^h  the  cc'Utral  con.imittee,  t<i  fur- 
msh  ai'I  to  Iie!liL,rereuts  williout  infraction  nf  the 
non-interference  to  winch  their  i,n  iwrnmeiUs  may 
in'  ])lei];4r(l. 

I-'nmi  the  outst  t  it  was  rccoi^nnsc'l  as  Ikuul,^  i,[ 
the  f.rst  MUportanci'  that  the  national  societies 
shouM  ha\<'  the  dcliniu'  recoijnition  of  their  home 
l;  >\-ernments.  as  without  this  all  \  oluntci  r  elforts 
in  time  of  war  must  he  erippleil  aiiii  inadequate. 
As  a  consequeTu.(.'  the  conterenee  oj|  iSfi:;  ri'coin- 
mciiijcd  all  central  conunittecs  to  put  thenisehes 
in  relation  with  thi'ir  \"arious  ,i,''overnnients.  Xor 
Were  the  rulers  of  ICurope  slow  to  see  the  import- 
ance of  oftieial  recoi^nition  and  co-ordination  he- 
tweeii  the  e.xt'cutue  ami  imhtary  dc  partnients 
and  this  powerful  \olunteer  arm\'. 

Thus  W'-w  \<v<  <\\<^h\  inti )  t'.xist;'nci'  t ln'  u< iw  worM- 
widi'  ramifications  wjn'ch  ha\e  made  it  jvi.ssihic 
tor  organised  nit  icy,  pit}',  and  common  sense  to 
hrin^L^a  eountei"-inlluence  to  licarou  all  the  various 
and  conflictinjj;  prohlems  of  war.  Keseue,  repair, 
even  prr\ cnl  i' mi  and  construi  ti\'e  torce  h.ave  risen 
in  ( ij)])osiliun  to  (lestructive  i  Kinents,  and  possibly 
at  .some  time  in  tile  future  the  ultimate  extinction 
of  war  from  the  earth  ^^"lll  be  dated  front  the  day 


Treat)-  of  Geneva  and  Red  Cross 


3'9 


whrii  Hi'iirv  Diinaiit  wrntr  hk  ;ij>]K'a1  to  \hv  peo- 
ple. The  natural,  rwn  if  uiu'<  >ii.sri<  )i!s,  iiillwcncc 
ofsiuh  an  organisation  as  tin-  kc<i  Cross  is  first 
to  inili.i^ralc  aii.l  tlu'ii  to  aholi^Ii  intrrnational  cru- 
dtyan.l  mupli'r.  I^.it  that,  rwn  fr,,in  the  outset, 
thcaholition  of  war  as  an  ultim;itc'  ])ossil.ilitv  was 
present  in  the  minds  of  tlte  nohle  -roup  oi  men 
who  ealled  tlie  internal  i^  nial  eonferdx'e  's  elcar 
from  the  Words  that  were  s])oken  in  that  tirst  con- 
vention—"The  Red  Cross  shall  '  aeh  warto  make 
war  ujx.n  it.self."  XursiuL,'  was  recognise<l  in  th.e 
re.solution  passed:  '■()n  the  <]em:.nd,  or  with  the 
eoncurrenee,  of  t  he  ,iii!itar>- authorit\- the  eomuiit- 
ttr  shall  send  volunteer  nurses  to  the  field  of 
hattle,  where  they  will  he  under  the  direction  ( ,f 
military  ehiet's." 

The  plans  and  principles  of  the  Red  Cros.s  were 

.n':-etteallv    i,rop.,;^ated     l,v     the     International 

<".niinittec,  and   met       ith  a   \\,,rm  response.     A 

pan!  aIiii]inL,MT!lhusi;isni  s])rea:'  from  country 

•' country  and    from  eitA-   to  i,,wn.      Local  coni- 

■■:ittees  w itc  formed  with  extniordiiiary  rapidit\-, 

:!  !  the  work  of  pivparatioii  tor  succour  and  relief 

'lit  (.11  all  o\-er  l-ai:-,  ,],e  without  renii.ssion.     Cer- 

■nany   especially     excelled    in    organisation,    and 

Ivaticed  m].idK-  to  an  asto,,ishin-  ].erfeeti,.n  of 

mtvicc.     To  stimulate  and  inform  the  puMit-,  cx- 

lii''itions  were  held  in  dilferent  countries,  at  which 

■!h>  Litest  and  best  in  equii)ment  and  outfitting 

■as  shrmn.  .and,  developing  from  tluse  exhibits" 

pcrn.aneni   Red  Cross  museums  hax-e  been  estab- 


3-0 


A  History  of  Nursing 


lishcd  in  several  cities,    such  as    Rtnckholm,    St. 
PeterslnlrL,^  Carlsrulic.  Moscow,  au'l  I\-iris. 

The  Rnl  Cross  societies  of  tiK^  ci'iitiiient  of 
Europe  have  takiii  a  jironiinent  and  er.erL,'etic 
])art  in  \hv  devrlojinient  of  nursin::,'  on  a  secular  and. 
.systematic  l)asis.  As  they  undertook  to  be  re- 
sponsible for  ser\-i.e  in  war,  it  became  nec(\ssarv 
for  them  to  train  nurses,  fur  the  existini;  mothcr- 
liouses  of  religious  orders  and  the  ill-tauL,dit  per- 
sonnrl  of  the  jufnlic  h'is])itals  otYere(l  no  reserve  of 
sul'iicient  ])rop()rt:ons  or  adajnabilit}'.  In  order 
to  train  nursrs,  it  was  nccessar\'  to  comniand  hos- 
jiitals:  lu'iirr.  oi.c  oi  the  first  and  most  arduous 
tasks  I  if  the  1'  leal  si  )cieties  was  t<  >  C(  iPeet  funds  and 
build  h'is]iita]s  which  sh;iuld  be  under  their  own 
mrma,i,'ement  and  be  capable  of  ]H_'inL:  utilised  as 
traininj,^  centres.  Tiiese  institutions,  therefore, 
performei]  a  double  duty — to  the  communitv  in 
which  the  lios]iual  was  legated,  and  to  the  countrv 
at  lar;_;e.  This  initiated  a  wom,an"s  movement  of 
vast  j)ro]iortions,  f'or,  while  nun  and  \\omcn.  in  a 
lari,fe  measure,  worked  side  by  side  on  terms  of 
harmony  and  equality  under  the  Red  Cross,  it 
nevertheless  followed  from  the  very  nature  of  the 
details  that  Women  often  took  a  foremost  anil 
major  share  in  the  responsiliilitw  Thev  ni>t  onlv 
raised  money.  >,'atherr(l  the  su])plies,  built,  often 
administered  ;mil  lu'lped  to  support  the  hos])itals, 
but  .also  wt-nt  into  them  as  nurses.  Women's 
n-lirl  societies  dt'X'elopcil  nunierouslv  ;is  auxil- 
iaries, and  bceanu'  tli'  >vi  luu'hlv  organised.  especi;illy 


ircat)  of  Cicncva  and  Red  Cro 


^.-. 


\2l 


I  n-rniain- 


Th 


:encral  liiK-  >  in  \\'Iik' 


h  th^ 


nurs- 


|>rrs(iniu'l  ot  ihc  Rci!  Cmss  S' it'ii  lios  was  dcwl- 
!  anmni:  the  nations  of  tlic  continent  was  tlu'ii 


A  central  or  1 


hospital,  nianaL 


CM 


..s  lollows:     .V  central  or  loeai 

hvlhc  local  soeiety,  an<I  at  least  ])artly  supported 


1 1\-  n 


■\-enue  from  ]>:[\  patients,  became  the  nnel 


eus 


itherhouse  tor  a  nnrsin''' stalt. 


W 


I  )men  Were 


receiw'il  to  lie  train(i!  as  nurses,  with  th.e  under- 
-'  M'-lini,'  that  t]ie\-  wouM  contract  themsehTS  for 

rioil,  mutuallv  ren(>w- 


ist   a  certain   ltuiti   pi 


ail' 


I  X  )SS  1  I  1 


1\-  lasting  for  the  nurse's  lifeti 


nu' 


Wii 


lie    this    mutual    contract 
])ra(.'ticalh'  a  ])art  and  ])arc 


asted,  the  nurse 
if  the  i::eneral 
.  ::!;])ment  of  the  Red  Cross  socict\".  In  time  of 
'.',,,••  slie  was  readv  for  militai'}'   ser\-ice,  her  ])]ace 

■  •■'.e  hos])ital  lieitii^f,  \-er\-  jiossihly,  filleil  for  the 
lime  ])L'\]v^  !>>•  a  laN'  \'oluntii'r.      In  tiiiu'  of  j)(,>ace 

',  was  eni])lo\ed  to  the  best  ad\-anta,L;'e  of  the 
,-.  K  ii  \y  with  which  she  was  u.nited  :  thus  she  miLrht 
lit' sent  1  I  ]iri\'ate  duty,  her  earnings  coniiiy!^^  into 
•■j  .-)cit  u-  treasury,  or  to  work  in  otlier  Ivispitals, 
inh  oilen  lound  it  easier  ;inil  chea])er  to  con- 
"■  ■'  with  a  nursini;  assneialion  for  a  L;i\'en  stalT 
"•  liarsi's  than  ti  i  train  and  he  nspi  m.silile  \\  ir  their 
I'Vn.      If  >hc  remained  ]iermanentl\'  witli  the  soei- 

"  .  she  was  ])r(  miised  su]!]ii  u'L  and  care  in  her  old 
•  ■  hut,  if  she  linallv  left  it  for  an  independent 
liii- ,<hc  pave  up  all  I'laiin  on  its  inijiloymcnt  of 
'•r  responsibility  for  lur.  Her  conditions,  in 
di-vt.  were  closeh-  modrlled  after  those  of  military 
xTvice.       Her     life     was     one     of     the    strictest 

VOL.    II. 21. 


322  A  History  of  Nursing 


discipliiH';  she    was    a    snldirr    of     a     t^MVat    relief 
army. 

As  a  social  ni'>\-c>nu'nt  ami  as  an  (Miiancipatnrv 
faetnr  ilu'  Rc(l  Cross  mirsiiiL,^  niMVcninU  of  tlic  d  >n- 
tini  ^\■as  of  an  inijiortance  that  is  liai'dlv  to  lie 
owr-cstinialiil.  It  was  ilislinctly  a  lon^L;  step 
torwaril  towaril  social  anij  iToiiomic  f(|nalitv, 
thouL^h  liy  a  haril  roa<l.  Castt'  lines  !'reri\-c'<l  a 
.severe  1  ilow  from  ihe  extension  <  .f  Rvl  Cross  work, 
and  "confessional"  exelusi\-enrss  was  e\en  more 
st'rionsly  dama.LUil,  for  tlK'  net'essit\'  of  keej)ini^r 
their  (|uota  of  nurses  tilled  compellfd  the  Red  Cross 
to  disreijard  stetarian  reliL;ious  prejudices.  An 
intellectal  fri-eiloni  ne\'er  eiijoyei]  1)\-  the  deacon- 
esses was  thus  ]iossiMe  for  the  nurses  of  tin  Red 
Cross  fas  the>'  were  always  calU'd,  so  lon<^  as  they 
remain(-d  iu  the  employ  of  a  Red  Cross  societv). 
and  a  tU'er  social  element  [,'a\-e  a  more  normal 
atmosphu-e  to  their  communities.  Most  imjiort- 
ant  of  all.  for  c\"olutionar\-  ])urposcs.  was  tlie  fact 
that  it  Was  far  easier  to  terminate  the  ci  mtract  and 
honourali]\-  leave  the  Redi  Cro.ss  ser\-ice  t<i  take 
up  self-su]>port  on  indej)endent  lines  than  it  wa.s 
to  leave  the  di'aeonessi's'  Motherhouse,  for  a  cer- 
tain sense  of  ])ul)lic  decorum  (or  narrowness)  was 
shoid<ed  in  th<  latter  case  hut  not  in  the  former. 
Indi'cd,  the  \  er\'  conditions  (4  Rid  Cross  ser\'ice 
almost  compelled  a  st(>ad\-  exodus  <if  nurses  from 
its  control;  for,  \\hile  on  the  one  hand  it  was  iin- 
jxirtai.t  an<l  necessar\-  to  train  as  lar^c  a  numher 
as  ])ossilile,  on  the  other  hand  it  rapidly  became 


I'lc.ilN  ot  (icncva  and  Reel  (.  ro.-^s 


■•  1  ■» 


fin;inci;il  iinii' issiliiiit\'  iMsup]"'!!  ,    1  ihrir  nur: 


ilcctn 


tlv 


HI 


md  sickness,  bt-rausc  " 


1'  th 


cfinliniK'il  ohli^'.iliitn  to  ImM  funds  ani!  resources 
of  all  kinds  in  readiness  for  the  jxissiMe  demands 
i)f\\ar  time.  Ini]»Mrlant  as  the  jihasr  re])i\sented 
hv  the  deaconesses'  movement  had  been  as  a  slej) 
toward  democracy  and  education,  that  of  the  Red 
'VohS  V.    nt  far  hevond  it  in  secularisation  of  the 


iiirse  s 


calhi 


api 


]n-v]i 


iration  f'>r  still  furthi 


th 


e  delinilimi  of  Iil'T  status  and  in  hi_r 


advances  m 

training. 

On  -\u'  technical  side  of  inn-sin,::  the  Red,  Cross 
has  been  a  faclm-  b  )th  for  ^^ood  and  for  poor  stand- 
ards. Its  nurses  in  C' mtiiK'ntal  C' luntries  ha\"e 
often  bi-en  well  and  ■arefull)'  iraine  ,  In  SMine 
C'liuntries  the  Reil  Cross  nurses,  as  lhe\-  areealK'd, 
stand  in  the  \er\-  frmU  rank  fnr  abilit\-  a.nd  thor- 
uui,'h  ])reparalion.  ( )n  tht'  other  hand,  the  \-ery 
nature  of  the  Red  Cross  societ  -  eneoura^^es  \"ob 
unteer  serxiet,-,  and  while  this  arm  ni  the  service 
can  and  does  do  ina,i,uiitieenl  work  ir.  .general  relief, 
the  same  cami' -t  be  saiu  of  ■  in  nursini;,  whicii  a 
superficial  trainini^  must  abv;  >  render  incom- 
])etent.  La\"  workers  of  all  M'cial  ,i;rades,  Irom 
attt'tidants  to  princesses,  ha\'c  had  a  ]iassion  fn\' 
so-called  arnu'  nursiniL;,  'Ahich  has  promote'!  hcjrt 
courses  in  bandai^in.i:;  an  1  in  first  aid.olten  hastih' 
j^iveii  in  thi  presence  of  some  emerj^cncy.  This 
has  been  es])ecially  true  of  those  countries  wliere 
the  Red.  Cross  has  been  least  thorou.^hb.'  orL;an- 
isc',  and  has  most  retained  a     oluntcer  character; 


"M 


324 


A  Ilistorv  of  XursiiT, 


I'lit  this  cfitii-isin  is  l';!r  less,  or  (•\-('ii  not  at  all. 
ap])!Ral>lr  in  ihosc  cMiiiirrirs  where  tlu'  Rcl 
(.'ross  sxstcni  has  jiceii  most  M'rioiish-  lookcfl  ui)'in 
as  an   inijiortant   aian  of    the   puMic  .serxacc. 

In  countries  where  thi'ancat  nl  inirsint^orders  lia'l 
thrown  out  modern  offshoots,  as  in  .vustria,  where 
the  Teutonic  KniL;hts  ah-ea<l\-  had  quite  an  active 
r'le  in  llie  ri  lief  of  the  \\ounded  in  ^var  time,  tlie 
Red  Cross,  n -t  xeithout  tlie  exercise  of  ce)nsideralile 
diplomacw  iranied  hanui  iii'ious  workiiu^^  agree- 
ments x\ith  them.  The  oi'der  of  St.  John  of  [cru- 
salem,  wiio^e  modern  liranches  in  (ierman\-,  Italy, 
ami  elsewliere  had  i^'rown  aristocratic,  and  prac- 
tised a  somewhat  aeadt-mie  philant hro])\-,  was 
stimulated  to  some  modifii'ation  of  its  old-time 
waws  by  the  xa'^orous,  democratic,  enthusiastic 
\'onn(,r  society  ot  the  Red  C'mss,  and  in  some  coun- 
tries co-operation  between  the  two  dcwloped  to 
a  satislact'  >rx  de-ree,  while  in  others,  where  church 
lines  an<]  hereditar\-  titles  are  too  e.xclusivc, 
they  ha\-e  not  united,  but  recognise  each  other 
andcablw' 

The  first  .threat  test  of  the  Red  Tross  or^^anisa- 
tion  cajue  with  the  war  of  iSji.and  was  trium- 
])hantly  met.  Miss  (dam  IJartoTi.  who  afterwards 
established  the  work  in  the  United  States,  was 
prn-ilcgcd  to  accompatn-  the  Swiss  committee 
throuL;h  the  war  of  iSri.  and  wrolc'  as  t'ollov/s  of 
her  experience  thei\'.  com])arinL'  it  with  her  recol- 
lections ><i  the  t  i\al  War  m  Auu'ne'a,  when  she  had 
'  Tlu-  KtJ  Cro>s,  (nistav  Moyr.ifr.  p;i    :■>   40. 


Treaty  of  Geneva  and  Red  Cross 


3-^5 


also  '/well  active  V(  luntctT  scn-icc  on  tlu'  haltlc- 
fk'id.  and  had  st'cn  untold  horrors: 

As  I  journeyed  on,  and  saw  the  work  nf  the  Red 
Cross  societies  in  the  field,  arcoini.lisliiin;  in  f<iur 
months  under  their  systeinatie  uri^anisatiun  wh.at 
we  tailed  Id  aecMmjilish  in  tmir  years  wit  hi  ait  it,  ivi 
inistakes,  no  needless  sulTerin.i,',  no  slar\-in,L;,  no  laek 
of  eare,  no  waste,  no  eonfusiMn,  hut  nnhr,  ]ilt'nt\-, 
cleanliness,  and  comfMrt  wherexer  that  little  lla,<,r  made 
its  way — as  I  saw  all  this,  and  ynnvd  ami  worked  in 
it,  I  said  to  ni\-selt,  "If  I  Uw  to  return  to  my  eountr\- 
I  will  tr\-  to  make  our  jieople  understand  the  Red 
Cross  and  that  treatv.  "  ' 

'  History  oj  tlu-  RcJ  Cro^i.  i>.  jg. 


(MlAl'Ti:i<  VIII. 


I'Hi-:  nF.vi:L()PMi;xi' i>i"  xrKSiM;  in  .\mi:kic.\ 


\  A  7"  1 1 1'A'  llu'  ])ilL;rnii  fallu'rs  and  lUdlhrrs  laii.U'.l 
VV  (HI  PKiU'iulli  riK'k,  liriiiu'iiiK'  llu'ir  Spar- 
tan ilonu'si''.-  ('i!-.ti  >ni.s  with  tlicin  tlic\'  di'l  iKJt 
inlrciluci'  tin-  art  "f  nur  iiv;  \n[n  tlio  Xr-w  W'nrM, 
fur,  ]('U'^  IjL'lorc,  as  "Ac  ha\t'  sri'ii,  tlu'  Jrsnit  I-'a- 
thei's  1  it"  l-'rance  had  ]ii' iiuTrril  iiinu  I'.u'inr  aini  the 
Catliohc  SisttTs  had  tstalilislicd  liirir  ni-sinn  li' is- 
jiitals.  Ivxcn  lufdrr  tlial  time  tlir  Indian'^  liad 
jiraelisrd  tlnir  nidr  nidh'ids  ni  inrdical  and  sur- 
;.^i<  al  iRMtnu'nt.  and  in  tlir  mt)-  <la\vn  of  Instory 
the  A/.tt-i'S  and  Inras  had  laiih  their  lii)>])ita!s 
ai:d  taka'i:  can'  nt  thnr  sick. 

The  nrujanisid  sA'stcin  mI  nursin;;  iii  i\v  ])ri'\aihn},' 
in  the  I'mtcil  States  dales,  it  ina\-  Ik'  said.,  frMiii 
iS;  I ,  hut,  as  in  ICtvjland.  it  was  pi'eeed.'d  h\'  many 
t"ntati\e  L-tVdrts  thai  are  li'sn  ineally  iinjvirtant 
and  .si.unilicant.  I  li>s]>itals  are  the  cradles  of  nurs- 
inju;,  anil  \ve  may  ])n>])erl\-  turn  Jirst  to  the  oldest 
()1  -  lur  hospitals  the  I'hiladt'lph.'  ,  first  kn^wnas 
thi'  I'hilai!el]>hia  ahnsliMuse  and  later  as  "  Hloek- 
k'V."  and    \f   i^l1c\-u<'  in    Nc^v   ^^  irk  ('it.       The 


l)c\cl()pincnt  of  Nursin<^r  in  America 


-» o  — 

o-  / 


attcr,  Dr.  Caiiisk'  tells  us,'  ,ma\'  lav  claim  to  lie  the 
ildcst   hospital    imw    in    (.■xisli.'iu'r    in    the    I'nilt'd 


States. 


Akc  main'  nlher  now  s/rcat  institutions. 


its  ori,!L,nn  was  of  thi'  hunihlest.  Its  ^enealorry 
runs  hark  into  the  eit\'  of  Aiiister'lani,  anil  to  the 
times  ^\■h^■n  the  ])o(ir  v\Te  su])i)on(Mi  hv  thechureh 
in  a  inodrst  huiMin^  which  serwil  as  a  ])i » irhouse. 
This  eharit\-,  aivl  a  little  hos])ital  v'lieh  was  built 


the    West     1 


U'lia   C 


inu>,anv  at    tin'  suL^ua'Stion 


if  its   surLjeon,    were  the  two  roots    from,    whi.'h 


ileveloi)e 


tin'   eit\- 


hos])ital   of    H 


eUe\"ue 


Tin 


con'.pany's  hoS]>ital  dates  haek  to  the  month  of 
Dtvemlier  in  iO;S,  \\-hrn  the  \illa;.:e  of  \rw  Am- 
sterdam oid\-  numlieri'il  a  tho  .^and  inhabitants, 
and  was  the  first  one  built  on   United  States  soil. 


i6So  til. 


1 1  lios'iita!      \vas  si  >\< 


aiii 


huilihii'.^  1  -ovided,  ,and  slid  later  the  (diuridi  fund.- 


for  th 


e  poor  Were  inei"eased  b\'  an  addition    from 


th 


e  citN     tatlu 


In    it;' 


I   a    new    huiMiUL 


fitto 


(1  up  ti  >  ser\-e  as  a 


uhlie 


W'orkln  lusc 


Was 


ami 


I  I'l'isc  of  C'l  )rreet 
f( 


H  'U    I 


if    New    V 


T 


ure  Were 


rimms  tor  various  kiiiils 


alii  lur,  siunmni/ 


etc 


quarters  for  the  family  of  the  kee]K'r, 


and  rooms 


for  an  infirmar\-  of  six  1 


H'dS. 


Thi,>- 


huiMin''. 


tlu 


immediate  anet'stor  of  Htdlevue.  stood  where  the 


tia 


11 


low  stands. 


Ast 


line  Went  on  it  was  .se\- 


era!  times  ri 


hUli 


aiii 


enlari'e' 


T! 


Hell. 


ii   present  site  <  if 


vue  on    tlu 


ast    Ki\a'r.  with  a  house  whii  h 


'  An  AiiOttnl  of  Bcdcvuc  Hosfita!.  -Wii'  )'ork.  hy  Robtrt 
l".irli-k',  MI)..  i)ul)iisho(l  by  the  Society  of  Ahitnni  of  Hclk- 
vuc  Hcspitiil,  Nfw  York,  iS()3,  ]>.  i. 


y.^ 


A  History  of  Xursiiiu 


brtMiiio  thr  nm-lrus  Ml"  the  first  P)cllc\-iic  hnspit.il, 
w:;.-,  punhasril  by  tlir  fity  \v\[h  y  mu-  haslf  m 
I7g4,  a  thi\'aU'iU'il  c])i<l(.'niic  <if  wllnw  k'\-(r  lia\-^ 
in<j:  catisnl  thr  fit^-  aTitlidrilics  to  ]inp,;a'  a  "  pist- 
il'kisc"  tiir  the  (iiicrm'iu'w  Thr  principal  huililiiit; 
(in  tlu'  (Idiiiain.  Was  a  tWd-st'Ty  ai",il  .garret  house, 
ami  the  I'statc  which  ^^■as  \-cry  hcaiitiful,  had  lucn 
nanu'ii  !i_\-  the  o\\iu'rs  1m  IK-Nau'. 

I'or  a  nuri'ur  ~)\  yiars  it  was  usol  <inl\-  when 
ihcn-  Was  \('ll(iw  t'r\-ir  in  the  titw  liciiiL;  t'l ir  this 
])ur])('sr    plat'c'il    I'lKJcr    the    niana^vnicnl    n\'    the 
Health   Hiiafi],    hut     hi    iSii     nior^'    i^numil    \\as 
hou.ulit:  an  Hind  it,  ,and  a  new  ahiisliMnsr  Iniilt.    The 
eornrr-stiMic  was  laid  July  jij,    iSi  i.      I\'l,i\-cd  hy 
the  War  i 'i    iSi:,it  was  onl\- tinisb.ed  and  o])rned 
in    Ai'ril.    iSk.-    with   llic   .ilnishc  mse  (]i;.irlers,  a 
jirnitenliarx  ,  t'-L'ether  with  w.ards  Imv  the  siek  and 
the  ins, mr  all  in  th'- s.mie  hnildini^^  w  ith  ll;e  nxmis 
fur  the   risidrnt    ])h\sieian.   the   wai'den,  and   tln' 
attendants.     TheoM  L,n'r\' sti  mr  structure  fmntini,' 
the  broad  arm  nl'   the  se.a  cillcd  the    ICast    Ri\(T 
I'lnked  diiMiided  and  interest  ini,'  \'  ith  its  cxtensi'.t 
^reen  sweejtut"  lawn,  ,ad  irned  with  a  t'ew  line  old 
trees,  but  it  has  hai!  ;i  tenable  hist'-;-\-.      The  yKi'.i- 
pers  munberei :  I'rnni  sixteen  hundreil  t'  >  twn  tlvM- 
s,.iid,  and  .anioiiL^  them  Were  iiiteii  ,as  ni,an\'  ,as  two 
hnndred  sick.      l^jn demies,  arisiiii^'  fr.  im  nnsanilar',' 
coi:(]iti''ns  and  <  i\  eren  iw  dinij,  were   I'rcijucnt  and 
se\'ere.     T_\phus  !i  \er.  the  sinister  CMmjianion  of 
tihh  and  miser>'.  imw  all  bnt  uid^nnwn  in  Ainerie:!, 
was  then  common.     The  phxsician.s  were  cruelly 


-y      !S 


Dcvcii  ■T)nicnt  of  Nursing  in  America  ^j2i) 


Wi 


)rked,  for  only  ihroc  werr  assi.L^ned  to  sr.por- 


Vl>' 


f  he  w 


hj  )k' 


liousehoM,  b<  .ih  .sick  ami  wvll.    Thi 


•irscs  (so  callcil)  were  (letai'  <\  from  the 


)nson. 


were  appointc 


ti, 


proportion 


nr  f, 


or 


ten  or  twenty  patients.      Political  jol)bery  wa.s  rife, 

nd  the  positions  in  the  hospital  were  j.,n\-en  to 

I)  '  ■    al   huichmen   \\ithout   the  sli"ht( -t   r(>'';ir<l 


tn 


:u'ir  unfitness  L  r  their  trust.      Dur 


mi:  ni;:nA- 


\-('ai'.-  ni 


int:  but  horrors  existed  at  I 


H'llevue. 


iSjfj  Dr.  Wood  complained  tliat  the  oeerrrowdin^: 
\v:ts  such  that  men  and  womev.  ill  with  s'"!all-])M\ 
h.  to  be  kc])t  in  i!ie  same  \v;  --d.  In  iS:;2  there 
was  a  frii^htful  epidemic  of  (drnkra,  and  the  dead 
lay  so  thick  on  the  floors  that  the  physicians  had 
t'l  step  over  their  bodies  in  makinj:  their  rounds. 
8,37  ^'^*-"  conditions  in  j^eneral  v/ere  sucPi  as  to 


in  I 


selves,  and  a  coni- 


.di"ck  e\-en  the  aldermen  them 
;r.ittee  of  investitjatif >ti  was  appointed.  Th(^  onlv 
pari  of  the  whole  buildinj:  whi(di  was  found  to  be 
clean  and  in  good  order  was  the  fcmak  de])art- 
ment  of  the  almshouse  division,  which  furnished 


a  silent  rebul 


m  its  cont-ast  to  the  icst.' 


The 


invcsti.i^atiui' comi-.iitlrc  reported  that  "the 


cfindition  of  ]Mle\-ue  hos]Mtal  was  sucdi  as  to  e\- 
''ite  the  most  pniL^nant  sxinp.itln-  for  it 


s  nc: 


Ct'- 


Mimates. 


:\ 


nioiii:  the  siM'cafications  thev  !.^a\-e  we 


no  \entilatioi 


r(- 
Ih 


Ith. 


1     no   cl-^'      iiL^,   ]>a1icnts    with    hi,i,d 
eil  in  b.ed  wilh  onlv  coanse  blanket.^ 


C'  i\ 


■er  them,  w; 


irds  owrcrowdcd,  iail  ft'\er  rife. 


'  Carlisle,  op.  (.ii.  ji.  37. 


330 


A  History  of  Nursin 


Tin  supplirs,  putrcfactinii  and  \-crniin.  It  was 
n']>()rtc<l,  furlhcrnioro,  that  tlie  resident  ph>-.sic;an 
witli  his  studnits  (two  onl}-  excepted),  the  matron, 
and  the  nurses  had  lift  the  I  la.ildin'^e ' 

[)r.  Benjamin  ():;len,  a  former  resilient  whose 
administration  had  ! -eeii  iipri-ht,  was  askcM]  to 
return,  and  did  so,  and  succeeded  in  elTeetini,' some 
reforms  in  (h'seijihne  and  in  sohdnL;  the  problem 
of  sup])lies. 

As  a  result  of  this  invest ij^ation  a  redistribu- 
tion ol  the  inmatc^s  was  deeideil  u]vin,  and.  in 
iS  :;6,  the  male  an^l  I'emale  prisoners  were  removed; 
in  iS  ^7  the  sm,dl-]>o.\  eases  Axc-e  pro\-idcd  for  in  an 
institution  on  lilaekwi^U's  Island,  and  thither  alsM 
the  insane  patients  v/cre  removi'd  in  iS:;();  but  the 
almshouse  and  hospital  reinaincd  torrctJu'r  under 
the  one  ro,  ,f  until  i(S|S,  wln-n  tlK'\-  were  se]):irate(l, 
and  thc^  stone  piK'  of  Hellexaie  Iie.^an  its  career  as 
a  hospital.  This  fin.-d  stej)  in  reform  was  hastened 
b\-  some  toreible  U>tt(-rs  th  a  had  a])]>eared  in  the 
I'.roiin-  i\'st  jiointim,'  out  the  m  iladministration 
and  tln'  liiL^h  death-rate  I'about  25  ]»e-  cent.)  of 
Bellexaie,  and  which  wcri'  su])])osed  to  ha\'e  been 
written  b\-  l)r.(  iriscoiuof  the  Health  Department. ^ 
This  new  dep.irture  \\-,as  also  consistentlv  su]i- 
j)ortt'd  b\-  lhr  ni'-.st  distiiii^-'uished  members  of  the 
nudicd  ;)rofrssi(  iti,  man'e  of  v/hom.  esjueiallv  Dr. 
J.  R.  \V(K;d,  li.iil  urL;ed  a  chani^v  in  t!ie  manner  uf 

'  Carlisle,  op.  cii,  p.  jg. 

>  Observations  on  the  medical  orjj.inis.itiDn  nf  the  hospitals 
at  Bellevue  ami  Blackwell's  Islam!,  Ort.  ;o,  Nov.  i,  5,  and 
0,  i>S45. 


DcNclopmcnt  of  Nursing  in  America 


jj 


makini,'  nu-dical  apijnintmcnls  in  the  hospital. 
Ilcrctofori'  these,  like  the  nther  oliiees,  ha-l  lieen 
used  as  piilitieal  rewards,  but  in  1847  a  new  era 
bc^an  with  thr  erealion  of  a  Medieal   Pxiardi. 

Xor  had  the  profession  IxM'ti  aUni^r^^her  indif- 
lerent  to  the  disyraee  attaehitiL,^  to  the  s^"sten^  of 
nursiii^i^.  At  the  time  of  the  si'])aration  of  t'fie 
alinshouse,  and  ])re\iMusly,  when  the  Medical 
Heard  was  a])j)i  >inted,  the  ph\-sieians  had  ])ro- 
tested  against  tln'  internal  conditions.  In  1857 
tln'v  had  (jl)jeeted  to  the  t'inpli  >vnii  iil  of  j.)risoners 
•  '  ])aupers  as  nurses,  and  some  had  asked  that 
>:■■■  rs  iif  (dia-at)'  be  placed  in  the  wards.' 

.\n  interestin.i;  bit  of  ne^atiw  testimon\-  as  to 
ihe  status  of  nursini,^  in  those  da}-;;  is  furnished  ]>v 
..:)  article  written  in  iS:;f),  descriliini.':  Belle\-ue 
hospital. ^  In  this  article  then.'  is  not  one  word 
alii'!it  the  nursin;^  o'-  thi'  cai'e  of  the  patients. 

In  Philadeljihia.  Hloeklev  also  br!.;an  as  an  alms- 
h'tuse.  It  su])])orted  and  ein])lo\-ed  the  poor, 
received  or])hans.  the  insane,  and  the  sick.'  Its 
■rn-sint,'  history  is  e(|ually  terrible  as  that  of 
Ik'llevue,  and  e\-en  m"Vv  of  its  details  ha\-e  been 
record  I'd. 

'  .1  C\)i!:iry  of   Xiirsini;.  with   Hints  tmvarj  the   Formation 
■  Ttainiiit;  Schools  for  Xiirsrs.     G.  P.  Putnam's  Sons,  N'ew 
\"nrk,  1S76.      [)    14. 
•  "  History   and     .arly  ()rj,'anisatinn  of    I'.rlKvLic."  .V,  1'. 
•urn.  0}  Med..  May,  1856,  p.  ^^.Sg 

'  History  of  thr  rhiladilphia  Almshouse  and  Hospital  from 
■  A.'C>)ni/'j;(j  of  the  iSth  to  the  end  of  the  igth  Century. 
>nii.ilc<l  an.l  published  by  Charles  Lawrence.     Philadelphia, 


S3^  A  IIist()ry  of  Xursing- 


III  17J1)  tlh'  Overseers  of  tlir  Pd.ir  presentee]  a 
mcnioi-ial  tn  the  Assrm!.!}-,  askinL,^  fnr  a  ,i,'rant  of 
monex-  lor  (lejJciKlent  ])c-rs()n.s,  for,  althout^^i  Phila- 
(]el])!iia  had  liad  an  almshouse  froni  171,:;,  it  was 
then,  and  ahva\-s  had  lieen,  supjiorted  l>y  the 
iM-iends  for  their  own  nunnhers  onlw  The  vStatt.' 
.^ranted  the  nione\-  in  17:50,  the  .i^M-nund  was  hfniijht 
and  the  er.'etion  of  a  hriek  lanl'hni;  was  hcj^am  in 
the  followiiiL^  \ear.  The  historian  of  Blocklev 
says,  "Tlu'  Pialadelphia  hospital  is,  without 
doubt,  the  olde.Nt  hospital  in  eonlinuous  service 
in  this  coumr\ ."  In  17OO  the  ])aupers  numlicreil 
220,  and  in  17(17  new  huildn\i4S  were  put  u]).  Dur- 
ing the  oeeu])ation  of  Philadelphia  b\-  the  British 
troops  the  almshouse,  like  other  j)ulilie  l)uildini;s, 
suffered  sewrely.  A^^  soon  ;ts  tlir  troops  entered, 
the  commaml  was  sent  ti  >  Hloekk\-  to  turn  the 
inmates  out  to  make  nxnn  for  them.  The  Boanl 
of  (niardi.ans  had  the  eoura,^'e  to  refuse  to  ohcv, 
hut  to  no  awail,  for  the  patients  were  forcihh-  juit 
upon  the  street^;  to  n.iake  room  for  the  king's  sol- 
d'ers. 

In  170.^  an  in\-estigation  showing  "shock- 
ing ahusi's"  IS  reeorde(l;  in  the  same  \a'ar  also  wo 
comv  u])on  the  fii-st  nu'iition  of  nurses.  The  \cl- 
low  tewr  naged.  and  it  w.as  "  imT)ossilile  to  jiT-dcare 
suitalik  lUH-ses:  only  the  most  depra\-ed  c  '.atures 
could    l.e    hired";    .    .    .   "an    ah  .;i(lon(>d.   prfifli- 

'  It  w.is  in  tlie  oM  (Ju.iVer  .iliiT^bnimo,  .qcrnr.iini:  to  .\i:nes 
Rcpplior,  the  brilli.ant  essayist  ami  liistonan  (if  Phil.iJelphia, 
tlial  Kvanguiine  foiini  (iahrie!. 


Divclopnicnt  of  Xuisinj^  in  AiiKTica  ;>:i3 


It    u\. 


■at('  set  f 


i|     IllM-SCS 


\n< 


attcnnants, 


\vn. )    '  rmtcd 


(in 


Ih 


V  ])rM\-isii  Ills  aivl  c-nmf' irts  Irft  for  the 


SIC  I 


was 


AH  the  wiirk  i  ■!  thi'  hnusc.  nursini^'  iiicliiilcil, 
buppf'SL'd  111  lie  I'iMic  I)\   ihc  iniiiatc's,  aivi  tlicR-  is 
no  reason  to  1 
than  that  at  1 


kIH.\i' 


that  it  was  (>\   hi'^hcr 


LM-ade 


)iil('\  ar 


Thr  cR'atnu'iit  nf  the  in- 


<iCKlc\'  wa.s  csnccialh" 


sane  at  B 

if  in  other  places  it  was 

ftils  have  cnnu  down  t 


icartrendiiii'. 


or. 


iKul,  more  ineaiTe  de 


II     US. 


In 


ennceivalile  as  it 


lunds,  tlie  female  lunaties  were  -ander  th( 


ar-c 


of  a  mall'  keeper,  win  i 


^isti'il  1)\'  twi  I  male  ixiu- 


pers,  slept  ani'ini.^  the  fe.iiale  insane  and  tonk  the 
entire  maiia^'nient  of  the  \-i<ili'nt  c 


ises,  e\'i'n  tn 


tia 


thin 


tr,  or  waslmu 


and  drrssini,^  tliein.  Sa\s 
ihe  histiirv  (juoted:  "S)m'^  of  the  ])atients,  e\rn 
in  their  madness,  shrunk  from  this  rude  handlin^,^ 
anil  ra\-ed  witli  increased  fur\-  at  their  indecent 
exfxisur.'.  Re\-ohin,L,'  to  decenc\- as  this  practice 
wa.s,  it  was  not  without  diriiCult}-.  and  onh-  by 
'h'':rrv>.,  ahandoned."' 

Ii  A'as  also  till'  custom  of  that  inhuman  institu- 
ti'inalism  to  jH'rmit  the  lowrst  ami  coarsi'st  of  the 
pulilic  ra'ihle  to  \  isit  the  wa.rds  fo.-  tlie  insaiK'.  to 
lau;4h,  stare,  and  jeer  at  them  as  if  the^■had  been 
wild  beasts  in  c  u,-;es.  Hut  most  ])!t;ful,  jK-rhaps, 
ofalhvas  their  sutl'erini:;  from  (  old,  fur  in  those  da\-s 
thrPi'  wen'  no  central  heatim;  plants,  anil  ai)j)ar- 
(.■ntl\- -t  w;is  assumed  that  the  iiisani-  were  insensi- 
Me  to  decrees  of  tempi  ratui^e. 

"n!v  oiu'  short  interred;! mm  of  pciec  im  ike  tlie 

■  History  oj  llu-  !"nilad>  lpi;:.i  Aliii!.:u>n.\,-.  ji.  ly:. 


-«.i 


334 


A  I  li^tofv  of  Nursin;^ 


ImiL;  aivi  <lislrcssin.u  rci.i^m  of  x-i'ilnicc,  iK'i,'k'Ct,  and 
crurU\-  m  I5lMckU^>-. 

Ill  tS^j  there  \vas  a  severe  eiiideniie  of  cholera, 
aiui  tlie  attenilaats  denian-k"!  nvre  w;i-ps.  T- 
kee])  Uiem  t'  >  their  tkities  tlie  ^^'a,Lres  were  increased, 
bvit  were  -[jroinptlN'  sj'eiit  i"-r  lii|iior.  An  or^y  of 
intoxication  en>ue.l,  and  t!i.'  htliurs,  crazi'd  with 
(h-ink,  fou,L;ht  hke  furies  oxer  thr  l>e(1s  ot  the  sick, 
or  lav  in  drnnki-n  stupour  heside  ihehodiis  of  thu 
(U'ad.  So  eom]iletc  was  the  demoralisation  that 
the  -uardian  a]ii)lied  to  Bishop  Kendriek  for 
Sistt'rs  of  ("haru>-  from  I^nunilsl'urs.^^  The  call 
was  ,-esi)onded  to  jirompth-;  indeed,  the  Sisters 
starteil  tM'o  hours  after  the  sinnnions  was  reeei\ed.. 
Thm-  took  in  hand  the  wlmle  desperate  situation, 
at  once  restored  order  and  disseminated  ahout 
them  an  .itinosplure  of  traniiudlity  anil  (luiet 
eneri/x'.  The  Sisters  reniaineil  for  sotne  months, 
and  their  work  \\as  so  (h  cijIv  a])preeiated  by  thv 
guardians  that  the  Connnittec  of  the  llouse,  in  a 
set  of  resolutions  commeniliiiL,^  tht  n*  p-eat  services, 
H'solved  also  that  i^lu-y  '  le  requestt'd  to  remain 
jiernianentlv.  This,  however,  Father  llickey. 
their  Superi^  >i-.  ne-atix'ed,  ,i,n\-in,i,'  his  reasons  at 
leT\L[th.  lie  'iid  not  consuler  Hlockley  the  dei)art- 
ment  of  charit\-  in  whieli  the  Sisters  could  lie  most 
usefulh-  emidoyed,  so  tlu'  i^mardiaris  were  oMii^ed 
to  Kt  them  '^'),  v.ith  ,L;lowin,i;  tributes  which  may 
Will  hax'c  ]>vcn  heartftdt.' 

In  1S51  the  lir:a  \\oman  ])h>sician  was  admitted 

'  Ilislory  oj  the  I'liiladclpliia  Almshouse,  p.  123. 


l)c\clu}jincnt  of  Nursing-  in  America 


J.O 


tn  the  service  in  I')l()ckl(n-.  l)nt  it  is  not  e\-i']cnt  that 
she  was  alli  a'.ti  1  t(  > 


i\<>  anNthin*'  to  niitie-ate  eon- 


(litimis.  In  1856  a  rejxirt  ,i;ivii\<,'  most  horrihle 
details  was  presented  liy  Dr.  Caniiilicll.  Tlit- iiistitu- 
ti'in  now  e()^l|)ri^e(I  small -])i>.\  wards,  de])artments 


fnr  the  insane, 


an  as\luni  tor  ciiijdren,  a  l\-in"-.in 


(k'j)artment,  a  nurser\-,  a  hi)s])ital,  and  alnishnuse; 


whi-rnn  were  eonerei/ati 


Ih. 


blind 


the  1; 


inie,  and 


the  incuraliles.     All  these  dei)artiuents  Were  over- 
crowded, withiHit    ])ro]XM-   c!  .ssilicatifm,  and    en- 


tire! 


under  the  care  i4 


th 


e  paiqxT  inniati\s,  < ir 


jiaiil  attendants  taken  I'mni  the  same  el. 


Tl 


le 


])hys!cal  conditions 
fact  that  I^docklew 


il  the  ]ilace,  t 
Bell 


'  10,  (m  ins/  to  the 


like  old 


evut' 


h; 


anva\-s 


lieeii  a  paradise  for  dishonest  contractors,  were  ii 


a  shajiietul  state 


Tl 


lere  was  ni 


and 


ani])s  Were  m  use. 


Tl 


>  ,L,Ms;  only  smal 


lere  was  no  katmdrv; 


IS    i^U'eii    out    to  a 


sm 


dl 


annv  o 


the  clothiui::  w; 
washcr^vomcdi.  In  the  hospital  dei)artments  there 
Was  not  a  water-closet,  and  onh'  one  hath-tub, 
that  one  liein,L:  on  the  men"s  side.'  Thesc'andal  of 
the  nursinj^^  continued    until    iSS.],  when    it    was 


ret'irnied   uniler 


M 


iss 


Ai 


ice 


]• 


isner. 


rreat 


\v(trk 


done  t)\- 


.M 


iss  rislicr 


oeionumc^r  as  it  does  to 


a    kiter    peritxl,   will    l)c    considered    in    a  later 
vnluine.] 
The  charter  of    the  Pennsylvania  hospital  was 


Iliston'ol  tin-  rhihhhh 


Ah. 


10.^ 


=  Sec  also  "  History  ..f  the  i"'iund.a  kjii  and  Devrloj.iiiont  of 
the  I'lrst  Hospitals  in  the  United  States,"  Aiiwr.  Journ.  oj 
insjnuv,  vol.  .\.xiv.,  1867  -68. 


^i 


MICROCOPY    RESOLUTION    TEST    CHART 

ANSI  and   ISO  TE5T  CHART  Nc     / 


I. (J  lio    ■■■       1 


12.5 


I.I 


1.8 


1.25 


1.4 


1.6 


^     APPLIED  IIVHGE 


336  A  History  of  Nursing 

granted  in  thovrar  ,75-       This  w:>s  thr  ilrst  hos- 
pital in  the  Unitr.l  States  in  the  i-n.per  sense  of 
the  w.nh  lor  it  was  .lesi-ne^l  s-.lelv  l<  n- the  eurative 
care  of  the  sick,  an.l  Us  fotnvlers,  with  an  enhyht- 
<.nnienl   unusual  indeed  at  that  .lav.  placed   the 
insane  in  the  cate-orv  of  those  who  were  ,11  and 
needed  treatment.     The  nanus  most  clo.sely  con- 
nected with  the  inception  and  f,nmdation  of  the 
IVnnsvlvania  hospital   are  the  lionoured   ones  ct 
I)r    Thomas  Hond.  who  niav  be  re-anled  as  the 
creator  of  its  plan.  an<l  Benjamin  Franklin,  who 
did  nv^st  to  realise  it.     The  ].vojeet  of  establishing 
a  hospital  in  Phihi<lelphia  had  been  talked  ot  by 
the  Ouakers  as  earlv  as    1700.     There  was  some 
sli-ht  (luarantine  provision  for  stran-ers,  but  this 
was  of  the  crudest  nature.      There  was  no  care  for 
the  insane,  who  were  s]-oken  of  in  the  petition  to 
the  Legislature  danvlv  the  work  of  Franklin)  as 
"^roin^"  at  larae,  a  terror  to  1  heir  Xei-hbours,  who 
aP'  dailv  apprrheiisive  of  ihe  Viob  tiees  they  may 
omunit."'     The    opmin-    of    the     Pennsylvania 
hospil  il  inau-uratr.l  an  era   of  earin-  for  the  in- 
sane  a.    patients    sufierin-    from   mental   disease. 
■  nid   'MMU-  them   a]>i)ropriate  treatment   instead 
of    treat um    them   as    malefactors.      The   cru<lity 
of  earlier  care  can  be  ..^ath.Tcd  from  a  record  dated 

jf,,(,.    ..j;i,i Com])layninjj;    to   ve  Court  that 

his  son  ICrick  is  bereft  of  his  naturall  senses  and 

'  History  of  the  Pnwsvlvania  Hospital  jrom  17^'  to  ''''«> 
by  Th.mias  M.irton.  MU.  Autlu.ns.Mi  l,v  the  Hoard  of  Man. 
ugcrs.     I'hilaiklphia.  181^7.     P  .5. 


DcM  lopmcnt  of  Nursing  in  America  i37 

is  turned  quyt  niadd  and  yt :  he  bcinj;  a  po^rc 
man  is  not  able  to  niaintaiin'  him:  Ordered; 
thatthrccor  four  persons  \)v  hired  to  build  a  little 

block  house for  to  put  in  the  said  madman."  ' 

None  other  of  cnir  hospitals  i)osscsses  so  l)enign 
an  atmosphere  of  peaceful  seclusion,  historical 
association,  an.d  di.L^iiilied  traditions  as  tlu'  I\'nn- 
svlvania.  Its  ample  s^rounds  and  ((uiet  situatioTi 
enhance  this  feeling,  and  ,'i  certain  old-world 
touch  is  given  b>-  the  pedestal  on  the  green  lawn, 
with  its  inscrii)tion  which  recites  the  bestowal  of 
the  Charter  by  King(ii'"rge  II. 

Its  earl\-  years  were  checkered,  for  e])idemies  of 
'  llnw  fe\rr  and  cholera  were  frcfiuent  and  terri- 
ivinj,',  and  times  of  war  brought  gra.\-e  troubU'S, 
when  wounded  soldiers  and,  Hessians  were  crowded 
into  it  without  notice  or  ap]ilieation  to  the  man- 
There  is  no  mention  of  the  early  nursing 
arrangenunts  exeei)t  one  allusion  to  "experienced 
and  trustworthy  i)er.sons,"'  but  the  hospital  had  an 
■ntercsting  experience  with  ^\onlen   managers   in 
.;i  advisory  ca]xicity.     In  1^:4  a  "  I'einale  I^uird 
■'Assistants"  liad.  been  tstablished,  and  inereaseil 
'.  numbers   the   following   year,   as   the   IIos])ital 
'oard  thought  that  ( onsideral)le  benefit  had  re- 
ilted  to  the  hos])ital  from  their  disinterested  ser- 
■a'. s.     But  in   1H27  a  collision  occurred  between 
*.!n'  "Female    Board"  and  the   Hospital    i?oard 
' '•  a  questifm   of    internal   order.     The   ladies 
i>ry  0}  the  Pennsylvania  Hospital  jrom  ij<i  to   /.S'yi, 


!1. IJ. 


33S 


A  History  of  Nursing 


'•  expressed  their  disapprovil  of  retainin,i^  a  certain 
employee  in  the  hospital  in  ain-  capacity  what- 
ever." History  dors  not  relate  who  this  employee 
\v;is,  l)nt  it  must  Iia\-r  1iren  an  important  one— 
possiLly  the  matron.  The  mana-xrs  refused  to 
accept  the  jtKl,c:ment  of  the  ladies,  and  they  re- 
.si,u:ned  in  a  body,  whereui)on  the  manai^^ers  de- 
clared the  I-'eniale  Board  of  Assistants  abolished. 

Tho.se  wh.o  know  the  frecjuency  and  ease  with 
whieh  a  ele^•er  but  umvliable  woman  can  deceive 
the  jud<,mientof  men,  an]  who  also  know  the  su- 
jK-rior  t\pe  of  woman  that  iho.se  Oiiaker  dames  un- 
donbtedlv])re.sented.  cannot  doubt  that  they  were 
ri-ht  and  the  llns]Mlal  lizard  sad]\-  and  totally 
wronjj;.  In  1S64  it  was  a-ain  jirojio.sed  t  >  have 
lady  visitors  ajipointed  to  tlie  wards,  but  only 
such  harmless  duties  as  reli,Lj;i.  .us  readini,'  aloud 
and  th(  like  were  allowed  to  them.  The  Pennsyl- 
vania hospital  establisluMl  a  tra in in,i,r school  in  i8;5. 

The  \\w  \>,vk  hospit.il,  the  next  in  age,  re- 
ceivcHl  its  charter  in  1771,  The  foundations  were 
laid  two  years  afttr,  but  before  ],cuv^  finished  the 
structure  was  burne(i  to  the  ;,M-ound,  an<l,  when 
finall\-  com]ileti>(l,  was  u.sed  by  the  British  and 
Hessian  soldii-ry  for  a  barrack,  so  that  it  was  not 
able  to  receive  patients  until  jamiary,  ijqi,  after 
It  had  recovered  from  th(>  disorganisations  of  war. 
The  Xew  York,  like  the  Pennsylvania,  hcm^  a 
wealtln-  hospital  in  which  the  most  prominent  and 
cultured  citi/.cns  were  deei)ly  interested,  probably 
h.'id  allend.ints  greatly  superior  in  grade  to  those 


I)i^vclopmcnt  of  XursinL^  in  Aiiicric.i  ;,- 


39 


of  city  hospitals  like  Hrlk'vuc  and  lilockk'V.  \Vc 
may  believe  that  they  were  the  liest  that  could  bo 
secured,  ^vere  projx.rl)-  housed  and  \\v\\  tri'ated, 
and  held  te)  a  eonscicntu)us  perfonnanee  of  their 
duties. 

The  distinction  of  ha\-in,L,^  made  the  first  attempt 
tf>  toa(di  its  nurse  attendants  l)elon_y;s  to  the  Xew 
\.'v]<    hospital:    a.ndto     Dr.    Valentine     Seaman, 
one  of    its   medical   chiefs,   a  reinarkablv  broad- 
minded  man,  is  due  the  honour  of  Iiavin^  eoncei\-e(l 
and  initiated   the   first  system  of  instruction   to 
nurses  on  the  American  continent.      His  serxdces 
to  the  cau.se  of  education  are  commemorated  bv  a 
Irtter  b-'J.Av  his  ])ortrait  in  the  hospital,  in  vdiieh 
arc  the  words:     "  In  lyijS  he  or^^anist  d  in  thr  .Xcw 
Yerk  Ho.sjMtal   the   first  regular  Trainin-  Seho, ,] 
for  Xurses.  from  which  other  .sehoojs  have  since 
been    established    and    extended    their    blessinirs 
throu-rhout  tln'  (\)mmunity."     In  a  comparative 
study  of  the  first  efforts  at  nursiiii;  reform  W(>  mu.st 
consider  this  .statement  .as  too  sweei)in,Lr,  in  so  far 
a.s  we  accept  Mi.ss  Nit^ditint^ale's  dictum  as  to  what 
constitute^  a  trainin,-;  .school,  hut  there  is  no  doubt 
ydi;aever  that   Dr.  Seaman  was,  in  many  of  his 
ideas,  far  ahead  of  his  time  in  liberality  of  \rie\v. 
In  connection  with  the  Maternity  deitaVttnent  of 
the  .\ew  York  hospital  he  orL,rani.se<l  a  course  of 
teaching',  and  i^aw  a  series  of  twent\--four  Ic^ctvres. 
mckuling  f)utliiie.s  of  anatomy,  pln-siolo},ry,  and 
the  care  of   childreti,   the  tliree  conehjdin<r' ones 
of  which  have  been  preserve- 1  in  a  small  vc^lume 


340 


A  History  of  Nursinij^ 


<-;ilI(  i|  1  he  Midhijf's  Moniti  r  awl  Mntlirr's  Minor. 
pulilishcl  in  iSoo  by  Isaac  Collins.  His  ifloas  on 
jTii'lwit'cryJiMWcvcr,  WduM  meet  with  little  med- 
ical appnilintiMn  t'i-ila\'.  for  he  reL:ari!e(l  iniihvives 
as  iniiisponsahU'  and  necessary,  and  believed  they 
.shouUl  be  thnnm^hly  and  carefnllv  tauijht.  In 
the  roll  of  hdnour  in  nursiti'^^  reform  he  must  stand 
hi^ijjh  with  those  admirable  Cierman  iirofessors  of 
medicine  v.ho  wrote  and  made  pn  ijian^anda  in  the 
latter  })art  of  tlu- ei,y;htecr;lh  eentur\-.  and  Ave  must 
always  re,L;ret  that  histor)-  has  preser\-ed  so  little 
record  of  his  actual  missionar\-  work. 

The  next  attempt  to  train  an  int(d!ii,'(nn  nursinfj 
personnel  liad  its  ori.L^in  in  Plnliilelphia  ajnont; 
the  Friends,  whose  predominance  in  that  city 
stamped  its  earl_\-  institutions  with  an  enliL,'hteno! 
philanthropy.  As  early  as  1 7S6  the  Philadelphia 
Dispcnsar\-  had  been  foundeil  lor  the  medical, 
surejical,  and  oi)stt'!  i-ical  ser\ice  nf  the  jioorin 
thc-ir  honies,  and  the  nri;j;inatMrs  of  the  disp(  risary, 
in  makmt,'  their  jniblic  appeals  tor  support,  had 
jiointed  out  the  need  for  such  jiublic  senacc  with 
feelinir  and  delicacy.  "  There  are  many  [thus  ran 
the  circular]  who  eamioi,  ,,r  dutdit  not,  go  to  a 
hosiMt.il,"  Such  iK'rsons,  the\-  contendecl,  cnuld  ho 
atteniled  in  their  liomes  without  beinj,'  subjectoil 
to  the  pains  of  sei)aratinf:^  from  their  families;  the 
care  pven  them  would  be  at  less  cost  to  the  com- 
munity than  that  of  hospitals,  and  it  would  more- 
over be  p)ssible  to  attend  to  tlutn  m  a  quiet  and 
refined  way,  "consistent  with  thosi'  noble  feelings 


\'.ileiiiine  Seaman,  M.II. 
A  iL-niliiiji  Surjicoii  of  tlic  .\t\\  \  I  rk   Ilosnital 

I  !  I-  lir-i  American  ]iliy.i(iaii  toadvncatc  tcaih- 

inj;  nurses 


•!! 


Development  of  Nursing-  in  America  341 

which  arc  inscj)ara].lc  from  \irtunus  ]K)-\-crly." 
Tiu  Innndcrs  of  this  charily  were  acliw  in  rcHc\- 
ini,'  the  necessities  of  patients  ai;plyint,^  to  it,  but 
no  reel  mis  \verc  kcjn  ln'h  >re  iS  :;;.  In  Jul\-  of  that 
year  a  ph>'sician  was  ])ut  in  charge  more  es- 
pcciall}-  of  the  obstetrical  ser\-it'e,  and  tlicreafter 
records  Were  ])rt.'ser\"ci!. 

This  physician  was  J  )r.  JMsep^h  \Varrin;4on, 
whose  acti\e  wish  it  had  lonij;  lieen  to  see  a 
school  !or  the  suitable  traininjj;  of  women  nurses 
in  connection  with  a  liospital  for  lyin,i,^-in  women. 

He  was  a  man  of  hd)et-al  opinions  and  hii^h 
ideals,  and  it  apptars  to  have  been  in  conse- 
quence of  an  urL,H'nt  a])i)eal  from  him  that  a 
lumiber  of  ladies  orj,^anised  themselves,  on  March 
5,  uS.v),  into  a  society  v>hose  constitution  was 
upened  with  this  preamble: 


Whereas,  in  our  widely  extended  and  densely  pop- 
ubtril  city  a  larire  number  of  poor  females  arc  subject 
ti'.creat  sutTerin.LT  and  risk  of  life,  durin,<jf  and  shortly 
alliT  the  ])eriod  (if  jiaruirition,  for  v.aut  of  competent 
nurses  t(.)  ,1,'uanl  then,  and  Tiu'ir  helpless  offsprin<;,  and 
uirry  out  tlie  directions  of  the  medii-al  attendant 
.  .  the  undcrsis,'ncd,  impressed  with  tlie  im])or- 
tance  of  tliis  subject,  do  associate  for  the  puriHjse  of 
providing',  suslainin<,^  and  eausin,^  to  lie  ir:.trueted 
as  far  as  ]iossibIe,  jiious  and  i)rudent  women  for  this 
purpose,  and  do  adopt  tlvj  followimr  re,t;uhitions: 

I.  The  Association  shall  be  called  'he  Xurse  Soci- 
ety (,f  I'liiladelphia. 

II.  Tl>>  I^o.-in!  ,,f  Manat^'crs  shall  consist  of  twelve 


34: 


A  Ili^torv  of  Xursinp;- 


females,    \vlio    arc,    or    have     been,   heads    ol    lani- 
ilies.  • 

After  electini;  its  nflicers,  llic  Imanl  was  to  take 
up  the  city  districts,  and  jilace  a  lady  visitor  in 
each.  The  society  was  t<>  einplny.  from  time  to 
time,  as  many  nurses  as  would  l>e  needed,  and  to 
.select,  fur  this  ]nir]M)se.  females  of  settled,  tjood 
habits,  quiet  anil  patient  disjiositions,  and  with  a 
sense  of  resjionsibility.  ()nl_\-  those  \\]v>  were  well 
recommended  were  to  he  emiiloyed  and,  it  un- 
suitalile,  they  were  to  he  disndssed.  on  the  advice 
of  the  physician.  There  was  to  he  a  loan  closet 
for  ihe  use  of  the  ])atients,  the  artiek'S  to  he  in 
chart^e  of  a  storekeejaT  who  wmild  distribute 
them  u]ion  an  order  of  the  vi>itor  tor  the  district, 
when  thev  would  be  carriedi  by  tlu'  nurses  to  the 
])atients.  The  nurses  were  to  hold  themselves 
in  readiness  to  be  called  ly  tlu'  ])hysieian.  Each 
nurse  was  to  spend  her  whole  time  with  one  pa- 
tient, and  was  paid  two  dollars  and  a  half  a  week 
by  the  societ\-.  The  nurses  were  superxisetl.  when 
ondutv,l)Vthelady  visitor  of  thedistrict  and  were 
taULjht  by  the  physicians  in  lho  lyin:.,^-in  depart- 
ment of  the  dis])ensary.  The  plan  of  instruetii'H, 
which  was  htUowed  from  the  time  of  foundation, 
was  arranj:;ed  by  Dr.  \Varnn:,,Mon,  and  included 
lectures,  with  ])ractice  on    a    manikin.     At    these 

1  The  comvU  to  Rojicrts  of  the  socioly  luivc  been  consulted 
and  data  jjivcii  are  taken  almost  entirely  from  them.  It 
is  this  society  that  has  t)een  already  referred  to  as  resembling, 
and  i)ossibly  beinj,'  related  to,  Mrs.  Fry's  work  in  training 
nurses  in  lilnjjl.md. 


1  )t\-tl()j)!TiL'nt  of  Xursiiiu;-  in  Aiiurica 


J  i.-i 


k'Clun 


mth  \hv  nur: 


md 


\'i>uni4  mcilieal  prac- 


tiiinncrs  Were 


tauijlu  lum'i. hrr. ' 


After  haxiivj;  scrwd  salisfactnHlv  f 


or  SIX  cases, 


thev    were    to      reeeixc 


nniropnate     certihcales 


si'jne'l   1)V  the   l)h\'sieiaii   in  eh; 


irL'e  ainl 


the 


;(!V 


visitor 


of  tl 


le  c  list  net.  and   were 


calls  to   j)ri\-ate   ihit_\- 


nurses, 


not 


then  eli,L,M!)le  for 
hey    Worked    siin]il\-   as 
mid\\i\(,-,  and    il  was    tlie    desire 


(if  the  societ\' not.  to  limit    its   usefulness  to  mIi- 
stctncal  cases.      Pi-aetieall\".  hnxw^wr,   these   were 


the  onh'  ealh 


The  "X 


urse  Comniiltee"  kept 


list  of 


appheants  tor  the  ;H'>itii»n  df  nurse,  niadi 


the  necessar\'  in 


(iuirie: 


and  reei  .inmeni 


led,  c; 


IKil- 


(lates  to  the  B 


.M 


joani  II!  .\Iana,i;ers  and  the  junsieians 
Accei)ted  candidates  Were  called  jin  il  latioiKTs 
Between  iS:;()  and  1850  the  Xurse  .'^"cieU"  ha( 
employed  lift>'  wnnien,  and  most  of  them  had  ar 


honourahle 


reei  m  I 


Onlv 


one   was   (h'oijind 


lor 


misconduct  and  tour  fur  inloxieaticn. 


In  i84()  a  Home,  the  need  of  A\hieh  had  loni 


'len  ur'Tenth'  telt ,  a\ 


IS  secured,  aiii  1  <  i]ient.'d 


Hume  and    Scln  ■>  il  in   iS^c 


lie  ajipiuMiUs  wt're 


now  adniitte( 


]iu]  111 -nurses 


and 


Were   hrst 


mstmcted     in    codkin^r     in     the     hume      kitchen 


"r    a 


fi 


eW    V.ce 


tim 


hev 


next    received 


a    course    of    theoretic, il    instruction    fr 


■(  >m 


th 


e 


[ihvsicians,  and  were  then  sent   out  {>>  eases  for 


v.eel 


at    ;i    tim 


T 


le   eiimmittee    i\'|Hirted 


the  results  of    the  Home  and  the  better  teaching 


Training   Schools   for    .Xurscs,"    ]\iu!.  Monthly,  D  .c. 


<:4,  C.  P.  Putr 


DostL 


it-'Odix  ij 


V  b. 


314 


A  History  o(  Xursin<'; 


to  lie  nvist  i:;ratifyinp',  and  thr  ap])licanls  of 
a  ln-iUT  i^Taiir.  Siil!  .ho  scnicc  rt.  iiiaiiu'il  al- 
most solidly  obstetrical,  though  the  managers 
greatly  desired  to  extend  it  to  medical  and 
surgical  cases.  XiK'^es  nho  had  received  thtir 
certificates  were  now  allo\\ed  to  remain  in  the 
Heme  for  a  moderate  rental,  and  take  ]trivate  duty 
calls.  V>y  1S5S  ^he  l^an  eloset  had  beeTi  extenik'd 
by  numerfms  appliances  for  unlinary  siek-nursing, 
and  a  resolution  wa.s  passed  b\-  the  society  re- 
minding the  public  that  nurses  would  be  supplied 
ft  >r  medical  and  .-^urgieal  cases.  It  is  lu  it.  howcwr. 
evident  from  the  reiiorts  that  there  was  any  train- 
ing given  them  on  these  lines,  further  than  some 
lectures  and  dimonstrations  in  bandaging.  In 
1855  a  leaflet  aii])eari'd  <igne<l  by  Dr.  Warringnon, 
Hannah  Miller,  aivl  .\nn  l)a\-is,  making  an  earnest 
plea  to  \-oung  wnnun  to  ent^r  the  luu-se's  callini:;. 
It  drew  attention  to  the  fact  that  the  demand  for 
nurses  was  far  greater  than  the  supply,  as,  out  of 
1656  calls,  only  670  could  lie  answered.' 

To  hv\\>  to  bring  the  work  before  the  public  an^I 
im])ress  its  importance  upon  the  students  them- 
selves, it  was  now  agreed  that  the  "  certificates  of 
approbation,"  as  the  nurse>'  certificates  were 
called,  should  be  formalh'  pre^ented  to  them  at 
the  annual  meeting  of  the  society. 

'•  .\mi  D.ivis  .-ifterward  stuiiicil  imilit  ine,  and  in  iS6,^  wrote 
another  pamphlet,  called  Xttrsing  ihc  Sick  and  the  Training 
oj  Xiirscs.  This  was,  however,  chiefly  .-iddressed  to  the 
heads  of  families,  and  is  of  a  slight  character,  though  marked 
with  "ood  feeling  an<l  conunon-sensc. 


Dcxclopmcnt  of  Xursing-  in  America 


JO 


TIk'  rrpdrt  ot   1867  shovs  steady  prnjijrcss.     It 
give?  a  list   of  "i^n-aduati'  nurses"  residing  in  or 
registcrinfj;  at  iIk'  lldnic,  wnd  records  2^2  i)aUents 
as   havin,!,'    rceeixed    imdical    and    nursin;^    care. 
There  were  then  lhirl\-totu-  lady  xdsiiors  for  the 
districts,  some  districts  ha\i!i^  two  \-isitors.     The 
6()th  annual  rcjiori  i^ixcs  a  sli.uht  hislorieal  resume 
of  the  work  of  the  society,  and  refers  to  lln'  share 
(if  Dr.  Warrin.L^ton  in  its  formation  in  the  foljnwm.t,' 
words:     "One  of  the  jirinuiry  objects  of  Dr.    Jo- 
seph Warrington  in  foun^n'r.'.,^  this  societ\-  in  the 
Year  i8_'S  was  to  jirox-ide,  in  connection  \\ith  the 
hospital  lor  women  duriuLj  coniinement,  a  school 
in  wliich  women  wouM   he  ])ractieall\-  trained   in 
the  art  of  nursino:."     Th,     reference  to  Dr.  War- 
rington,  and   the  introduction  of  this  new  date, 
1828,  le.ids  one  to  supjiosi'   th.'it   he   had    had  the 
purpose  in  mind,  and  liad  identified  himself  with 
some  earlier  effort  than  that  rekiled  in  the  rejxirts 
quoted,    and    which   had,    prohalilv,    led    loi^ically 
to  the  estal.lisliment  of  the  ori^'anised  societ\-,  al- 
thou,L,di  the  fact  had  not  been  made  (]uite  e\ident 
:n  the  earliest  reports.     The  6()th  rejiort  savs  of 
the  school,  "It  is  the  fu'st    Xurse  Tiainin^,^  Scliool 
in  point  of  time  founded  in  America,  and  we  ha\-e 
the  record  of  but  one  in  lun-o.])e  of  l.^nL^iT  stand- 
ing,'."    The  70th  annual  report  bt-ars  on  its  title- 
pagje,  after  the  name,  the  words,  "  in  acti\-e  opera- 
tion   since    1S2S:    The    hdr-t    School    in    America 
established  to  Train  Women  as  Xurses." 

As  r.  pioneer  effort  it  is  certainly  most  interest- 


34^ 


A  History  of  Nursini.'- 


ing  anil  c'lninu  n.laMi.'  and  alT'ivds  a  wiluaMi'  stiuiy 
of  c()'ii])L'ra;ii  m  and  inudliiruTU  thi'u;.rl!t  in  adx'ancc 
(if  'iliDS.'  times.  Sincr  the  full  rcfunn  of  mirsing 
has  lirrn  diivrU'd  by  Miss  Xighlingak'  this  cxrel- 
ii'nt  lild  charit\'  lias  m  it  continned  tn  advantr 
along  the  whoU"  line.  In  iS.j;  it  extended  its 
t'ourse  to  one  \-ear,  liut  the  nurses  were  sent  out 
to  |ii-i\.iti'  ihuy  aftiT  three  nionlhs'  hosj>ital 
service.  'I'Ik'  hours  ix'tained  the  old-fashioned 
stanij):  — risi'  at  ^.^o:  wards  at  (»;  hreakfast,  7-8; 
(lailv  dutv,  1  2]  hours. 

The  next  oldest  school  in  Philadelphia  is  that 
of  the  Woman's  tiospital.  This  entire  storv  is 
oiu'  of  pioneer  struggle  to  break  new  ])alhs  along 
the  latelx"  v.on  attd  diflicult  roa(i  of  medical  e(lu 
cation  for  wonit..,  and  the  nursing  shared  in 
the  dit'liiulties  of  the  whole  work.  Tile  nurs- 
ing school  h.id  I.i(n  planned  and  hojieil  for  at 
.1  much  earlier  date  than  that  of  the  begin- 
ning of  actual  work,  for  it  was  ojicn  to  ])n]>ils  in 
iSdi,  Init  none  oiYcrcd  themselves  muil  18O:;.' 
It  did  not  advjince  mucli  before  1S7J.  when 
it  received  an  endowment  which  enabled  it  to  ex- 
tend its  advantages,  and  little  by  little  it  has 
l)rought  up  its  standards  to  those  of  the  ]>resent 
clay. 

Another  intere.-.tinj.^  early  nursing  foundation, 
which  has  also,  and  with  belter  reason,  been  called 
the  "first  training  school  for  nurses  in  America," 
Wiis  that  of  the  New   England  lIosi)ital  for  \Vo- 

'  "TraininiL;  Schools  for  Nurses."  l\'ii».  Monthly,  cit. 


Development  of  X  irsino-  in  America  347 


men  and  Chili livn.      It   al'.;o  is  closdy  bound   up 
with  the  histiiry  of  the  first  medical  woTnen  <  ,f  onr 
C(iuntr\',  espeeially  witli  that  u\    Dr.  Marie  Zakr- 
zewska,   who  was  mu'  r>t"  the  most   lirilli.mt    and 
nri-inal  in  force  and  ability.     Dr.  Zakr/.ewska  was 
a  German-Pole,  hit,fhly  educated,  who  was  familiar 
with  the  trainint^r  f<.r  nurses  then  «^ivcn  in  the  secu- 
lar school  i,\  the  Charite  hospital  in  Berlin,  wlirre 
she  had   studied  midwifery,  and  later.  iiK'dieine. 
As  she  was  not  permitted  \n  take  a  medical  degree 
in  (icrmanv.    she   came    U>   America,    wlure    Dr. 
Klizabetli  r.lackwfll's  hen.ie  courage  and  eminent 
ability  had  recently  "  h;immered   at  the  gates"' 
"t   medical   edueatiun   i,,r  wi.men.-      In    iS;()   Dr. 
Zakrzewska  was  ai;|)ointed  to  the  chair  of  obstet- 
rics in  the  \cw  Kn-I.md  Female  College  of  Boston, 
and  It   was  due  h>  her  advice  that   the  trustees 
(M.iblishcd  a  small  hospital  and  clinical  <lepart- 
nunt  in  comiectidii  ^\i^]l  it.     'flie  rcimrt  of  i8:;()- 
fiosays;     "■  In  addition  to  the  work  already  sp' 'kdi 
nf  fin  till"  hosi)ital  and  clinics)  we  early  expressed 
our  hope  to  receive  and  instmct  Wfimen  desiring 
t"  be  trained  ff)r  nurses.     This  hope  we  still  cher- 
ish.    We  ha\e  had,  as  yet,  but  one  application  in 
this  department." 

In  the  next  two  years.  Dr.  Zakrzcwska  trained 
SIX  nurses  here,  though  they  did  not  receiw  cer- 
tilicates.     In  the  early  }>art  of  1862  she  withdrew 

'  I'hr.-iso  u.scrl  l.y  Oliver  UVndell  Holmes:  M,:li.„l  /-.,-. 
Scholastic  and  BcdsiileTeachinR."  p.  agg. 

■  I'or  interesting  details  of  that  struRKle  sec  Dr.  HU  kuills 
""k  cited,  p    201 . 


hs 


A  Hisioi 


■\'  of  Xursiri_L( 


from  this  posiiion  lo  take  one  of  wider  usefulness 
ottered  to  lu-r  l)y  ;i  .unnij)  of  nolile  and  courajjcous 
innneers  in  edueatiim  who  had  or<j;a!iised  the  Xen- 
Eni^land  IhispUal  for  Wonu'ii  and  Cliildren  and 
had  .asked  h''r  to  take  char}2;i-'  of  it.  The  honoured 
names  nt'  Ivdnali  L).  Cheney,  Lue\-  C.nddard,  houisa 
C.  P.oTid,  Lueretia  Freneh.  and  man\-  dtlu'i's  well 
kni  i\vn  ill  W'W  I'^n'^^land  are  l.nuiid  up  elo^ely  with 
tlie  history  dt  thi^  institution,  as  will  as  those  of 
a  tew  lilnral  men  who  liclicved  m  i ijn^niu'.^'-  the 
.Uates.  The  ineorjioration  aet  d<'elared  the  obic-ets 
of  the  hospital  to  l)e  : 

I.  To  provide  for  women  medical  aiil  bv  ccmpe- 
It'iu  pliysicians  of  their  own  sex.  II.  Tn  assist  edu- 
cated women  in  the  practical  study  of  iiiedicnic.  III. 
To  train  nurses  f(<r  the  care  of  the  sick. 


The  lrainin:r  of  nunses  was  now  l)e}.,nin,  th'ni<ih 
ni  a  ]ireeisely  on  the  lines  of  a  trainin<,'  seln  » )].  \'et 
in  the  period  of  al)oMt  ten  years  before  the  ri-ular 
sehodl  was  established  Dr.  Zikr/ewska  tauj,'ht 
thirty-two  nurses,  and,  as  she  was  a  stric  t  diseipli- 
narian,  with  hij,di  standards  of  practical  work  and 
very  thoroujj;h  in  methods,  they  became  "exix'- 
rienced  nurses  "  of  an  excellent  type.  The  annual 
n  port  fnr  1864-65  mentions  "the  faithful  care  of 
( )ur  nurses  "  and  aj^ain  says  : 

Kach  department  of  the  hospital  is  under  the 
charjjc  of  a  head  and  assistant  nurse.  The  latter  are 
often  Women  who,  wishing  to  gain  experience  for  pri- 


Development  of  Xursin;^  in  Anuriea  349 


\;itc  imrsiiiL,'.  cnlcr  tlif  Imsiiital  lor  a  iirriod  nf  six 
niontlis,  cinrin;,'  wliirli  tiin<;  tlicy  jjivo.  in  cxchanjjn  for 
iiistnu-tion,  llK'ir  siTviccs  free  of  rcimincration. 

At  this  invscnl  inonu'nt.  tlio  lica-I  nurse  of  the  nu'd- 
ical  (Icpartnunt  is  a  woman  of  unusual  skill  and 
jrcncrosity,  wji..  serves  tlic  hospital  from  real  inter- 
est, having  twice  left  very  lueratixe  ])ri\-atc  nursin;,' 
in  (  nicr  t(j  take  charge  of  our  hcjspital. 

Till'  ro])nrt  f'lr  1867-68  savs: 

We  have  a-rain  crmsirlcred  the  subject  of  cducatimr 
nurses,  and  otter  the  advanta,i,'es  of  the  jiractice  of  the 
hospital,  with  board  and  washinjj,  and  also  low  waj^^cs. 
after  the  first  month  of  trial,  to  those  women  who  wish 
t'l  acquire  skill  in  tins  important  art.  As  yet  wc  have 
had  but  few  apjilicants  wIkj  are  willinj,'  to  j^'ive  the 
requisite  time.  We  do  not  feel  willing  to  be  responsi- 
lilf  for  the  fitness  of  a  nurse  who  has  been  with  us  for 
less  than  six  ni'inths. 

Two  years  later  liic  ri'jxirt  .sa\-,s:  "There  is 
great  dem.and  fnr  cotnpetent  nurses.  The  few 
who  have  faithfully  served  their  time  with  us  find 
more  than  they  can  (](,,  and  take  rank  at  once  .as 
superior,  first-class  nurses." 

In  1873  the  h(.si)ita!  moved  to  the  tiew  building 
rit  Ro.xbuPk',  and  the  modern  .school  ,,{  nursing 
<latcs  from  this  time.  With  ampler  accommoda- 
tions, and  reinforced  l)y  the  cnthusiastn  of  Dr. 
Su.san  Dimock.  who  was  just  hack  from  her  .studies 
in  Zurich  to  take  thi'  i-w>st  of  resident  phvsician. 
tile  managers  announced  in  their  report  for  187 1- 


;^i 


.O 


o 


A  I  li^tnry  (jI  Xursinj^ 


In  n;-ilci-  mitrv  fully  t"  caiTv  out  mir  jmrposc  oi  fit- 
ting' Wdimn  th'inmi^lily  for  llic  imifessi'in  nf  mirsin;,', 
wo  have  made  the  foll'AviiiLr  arran^Ljcnunts:      ^'nunt; 
women  of  suitable  acquirements  and  ch.aracter  will  be 
admitted  to  tlie  hospital  as  srliool  nurses  for  one  year. 
This    yt'ar    will    be   di\-ide(l    iiuo    four    periods:  three 
months   will   be  ,^iven   respeetively   to   tlie   practical 
study  of  nursing  in  the  medical,  sur<:ical.  ani.1  matcr- 
nit\-  wards,  and  ni.^ht  nursini,'.      Ifere  the  pupil  will 
aid  the  head  nurse  in  all  tlie  care  and  work  of  tlie  ward 
under  the  dirct  tion  of  the  attendinjj:  and  resident  plu- 
sicians    and    medical    students.       In    order   to   enable 
Women  entirely  de])rndent  upon  th.oir  work  for  sujiiiori 
to  obtain  a  lhoroui,di  trainin.i:,  the  nurses  will  be  ])ai(l 
for  their  w<jrk  from  one  to  four  dollars  jier  week  after 
the  first  fortnijjht.  according,'  to  the  actual  value  of 
their  services  to  the  hospital.    A  course  of  lectures  will 
be  1,'iven  to  nurses  at  the  hospital  bv  physicians  con- 
nected with   the  in.stitution,  bej^nnninu;  Jariuar\-  21st. 
Other  nurses  desirous  of  attending  these  lectures  may 
( obtain  permits  from  our  physicians.     Certificates  will 
be  given  to  suth  nurses  as  have  satisfactorily  passed 
a  \ear  in  jiractical  training  in  the  hospital. 

Thcsante  report  adds: 


As  long  as  we  were  in  the  oM  hospital,  with  space 
so  inadequate  to  our  needs,  we  were  able  to  carry  out 
only  partially  our  plans  for  training  nurses,  but  finding 
the  demand  so  constant  for  those  we  have  already 
trained,  and  the  need  of  good  nurses  so  great  in  the 
community,  we  have  n  >^^  determined  to  use  our  in- 
creased facilities  to  the  utmost,  and  each  year  to  .send 
out  a  small  band  of  trajncl  nurses.     At  present  we 


Development  of  Nursinq-  in  America  351 

have   five   in   training   for   the   lengthened   pericxl   of 
twelvemonths. 

The  rt'iKirt  <if  1S72-73  mentions  the  ^rreat  success 
of  the  new  met  ho.  I  of  training,  and  of  the  winter's 
course  of  twelve  krtures— these  l)eing  so  numer- 
ously attendrd  l,y  laoirs  fn.m  (,utsi(le  that  it  l)e- 
canie  necessary  to  regulate  admission  1,\-  tii-ket. 
The  resident  ])hysieian"s  report  tells  the  foil  ,v,-;ng 
pleasing  incident: 

Last  summer  the  nurses,  having  heard  that  tlie 
Iinspital  was  mueli  in  need  of  money,  gave  (me-lourth 
<■!  their  wages  fur  ilie  rest  of  the  year,  sayings  thev 
V.  aid  like  tM  (h,  this  nnu'li  f..,-  the  hospital  since  it  had 
dune  so  inueh  for  tiiem. 

The  imih.rin  of  the  early  da\-s  was  perhajis  n,  .t 
very  strict  in  uniformity.  "A  smii.le  ealieo  .Ir^ss 
and  felt  slipiK'i-s"  i.s  the  delightfull>-  lUl.s<.j)histi- 
e  'led  formula  giwn  in  (lie  rcji.  irts. 

The  first  nurse  to  receive  lur  '■ertillcate,  and 

I  has  since  Imvii  known  l,v  the  jmaid  title  of 

"The  i'irst  Trained  .Vurse  in  the   United   Slates," 

\v,is  Mi.ss  Linda   Richards,  whose  nursing  career, 

still  in  full  activity,  has  been  long  and  honoin-aldt>.' 

Miss  Richards  writes  of  tho.se  days: 

<M  the  five  nur.ses  in  our  class  I  first  entered  the 
Rchonl  on  the  day  it  was  opened,  the  other  four  C(mi- 
in«  within  si.x  weeks.'      Kvcn  though  the  course  was 

"If  this  first  class  of  nurses  Miss  Linda  Rirhanis  wnl  to 
HtMi'Vue  as  niKht  snperintonfiont  in  OctotH-r,  187^;  rcmaine.l 
th.Tf  a   year,  and   thc-n   w.is  otT.Tcd  the  j.osition  of   Sister 


35  • 


A  History  of  Xursiim' 


far  too  short,  an.l  the  ail\-anta,i,'cs  few,  \vc  five  nurses 
of  the  first  ehiss  were  \-ery  happy,  very  united,  and 
IJretty  well  instructed.  We  had  no  suy)erintendent 
of  nurses  —in  our  i<,moranee  we  did  nut  know  that  sueh 
an  otificer  was  neccssar}-.  As  1  look  I.atk  I  wondei' 
tliat  we  were  as  we!!  tau.^dit  as  was  reahy  t!ie  case,  and 
I  sometimes  feel  that  we  nurses,  ea<jer  as  we  witc  to 
learn,  instructed  the  pliysieians  nearly  as  much  as 
they  instructed  us. 

The  r.iiirse  .if  l^ctiiri's  aiinduiiccd  f^r  the  ^\•iIUer 
"'"  ''"^7  >^74  ^\''''^  ^i'"^  follows: 

Dr.  Zakr/.ewska,  i,  "  I'^sitiMn  and  ManiuTS  of 
.\tirses  in  Families  ";  1  )rs.  J-ainlx-an-lAii-usta  I'.-pe, 
J,  •■  I'h\si(ilni4ie-d  Sul Meets":  Dr.  vS.wall.  i.  '■  I'ood 
tiir  the  Siek";  Dr.  Dinimk,  j,  "  Siirijieal  XtirsinL,'"; 
Dr.  Morton,  j,  •' Child!  )ed  Xnrsin^L;";  Dr.  Call,  i, 
"The  I'scni  Disinfectants  to  Prewnt  ContaLjinii "; 
Di".  Zakrzcwska,  i,  "General  Xinsiiii:  " 

Helen's  assistant  by  the  committee,  hut  declining  this  went  to 
the  MassiK-hnsetts  Oeneral  hospital  to  take  the  position  of 
superintendont  of  nurses  whieli  was  otTercd  to  her  at  the  same 
time.  Mrs.  Wolhauptcr,  another  of  the  first  five,  took  charge 
of  the  maternity  department  m  the  .New  En^dand  hospiiul 
after  gradu-ition.  then  went  to  lunevue  as  head  nurse,  then 
took  ehargf  of  the  Mrooklyn  Homeoy.athic  Lyinjjdn  hospital, 
and  followed  .Mi.ss  Kiehards  as  sufx-rintendent  of  the  Massachu- 
setts (leneral  training  sehool  when  the  latter  left  it  to 
study  in  EngLind,  finally  returning  to  her  former  post  in 
Hrooklyn.  A  third  graduate.  Miss  Woods,  went  to  Bcllevue 
as  head  nurse,  afterwards  holding  a  similar  position  .it  the 
Massachusetts  fiencral  for  two  years,  and  then  beenme  the 
first  night  .superintendent  of  the  newly  oiiened  Boston  ('ity 
hospital.  The  other  two  devoted  themselves  to  private 
nursing. 


l.iiula  Ricliarls 

I  ho  I  ir»l  Traineil  Nnre 

1  a  I.  en  after  hergr.iiiii 


Am 


Development  of  Nursint^  in  America  35 


Miss  janinu',  who  has  written  an  account  of 
this  school,  of  whicl'i  she  was  for  some  years 
suftcrintcndcnt,  savs : 

Ai  this  carl}-  period  there  seems  to  have  been  threat 
interest  and  entluisiasm  shown  1)\-  the  jaipils.  and  tlu' 
(h/ctors  in  the  hosjjital   were  especially  interested  in 
teaching  them.     Dr.  Zakrzewska  tau<,dit  at  the  bed- 
side aa  the  sinijile  details  f)f  nursinj,',  and  all  the  nurses 
made  rounds  e\-ery  mornin.t,^  and  recei\ed  the  orders 
fer  their  patients.      Th.ere   were  no   head    nurses,   no 
superintendent.      Each    nurse    was    ^iven    char<,'e    of 
about  fnur  patients  and  was  made  responsible  for  their 
nie<lieines,  diet,  baths,  etc.      The  jihysicians  were  most 
e.xaetin.L;  and  critical  and  demanded  wry  much  in  the 
small   details  for  the  comfort  of  the   patients.      '1  he 
hcspital  was  \-ery  jKior:  the  empty  treasury  was  re- 
plenished only  week  by  week  r>y  the  jiersonal  efforts 
of  the  direct(,rs;  d(,ubt  and  ridieule  of  th.e  women  doc- 
tors had  to  be  met  bravely,  eonsecjuentlv  it  needed 
rourape  to  believe  in  tiic  possibility  of  the  success  of 
ti;e  wcrk.      The  nurses  had  to  be  most  economical  and 
supplement  t!a>  efh.rts  of  the  doctors  and  <lirectors  in 
every  way,   to  keej*   tlie   hospital   alive.   .    .   .      There 
were  only  tliree  women  in  the  country  wh..  were  flnnii; 
sur«;ieal  work:   Dr.  Clex.land  m  Xew' York,  Dr.  Eliza- 
heth  Ktllar  in  Philadelphia,  and  Dr.  Dimoek  in  Hos- 
^""-  ■   •   ■      T'-e  .';ehio()]  eontinueil  to  j.,n-ow  until  in  iSSi 
the  coursf  was  extended  to  si.xteen  months,  and  it  uas 
■'  .his  time  that  a  suj'erintendent  <>{  nurses  was  hrst 
i.ni])l()ycd.' 

'"The  First  Training'  School  in  America.'  ]-y  .\nna  ('. 
.lanmid,  Joints  Hopkins  Hospital  Xurscs  AluiiiiiivM,v-a:ini\ 
■^"V.    190.S,  pp.  i<;7-2oi. 

vol..   U. 2T,. 


■rt 


354 


A  Iliston-  of  Xursiii'T 


The  course  of  trainin^u;  in  this  sclimil  has  now 
licfii  cxU'mlr'l  til  ihrci'  wars,  ami  mnsl  of  the 
])ion('(.'rs  ha\"(' ])asst'<l  awaw  Dr.  Diniofk,  lifil'iant 
anil  rnlhusiastic,  jurishci]  at  soa  \\hi.  n  slu-  was  luit 
t\vc'iUy-(,'i<^ht  years  of  a,L;i'.  Dr.  Zakr/cwska.  full 
of  years  ami  hommr,  reinaim-il  u])  to  the  eiiil  nf 
the  eentury  atti nilinL,''  ai^l  aihisury  plusieian 
(»f  the  Xe\v  ICn^lanii  ilos])ital  for  Wonn'ii  and 
Children.' 

The  little  town  rif  St.  Catherine's,  on  the  other 
siile  "\  the  Canailiaii  I'liriler,  emnes  into  the  ranks 
of  the  ])ionet>rs  at  this  ]joint  in  lunMimj;  np  a  hos- 
jiital  anil  ]iri  ixiilin^r  trainint^r  f,„-  nurses.  This 
eonununit\  ,  the  first  in  Canaila  to  follow  the  ex- 
ani])le  of  Miss  .\i,L;htin.L,^ale,  he^an  work  on  these 
lines  in  iS(, |,  and  (W\'S  the  develo])nient  and  suc- 
cessful carrvinL^  out  of  its  proji^ets  larj^-elv  to  the 
interest  of  Dr.  Maek.  ]3t'L;innint.;  with  a  little 
house,  which  was  rented  for  ei,L;ht  dollars  a  month, 
one  nurse,  and  a  steward,  the  hospital  ^rew  stead- 
ily, ;ind  Dr.  M.aek  lireame  snccessiyely  j'yri'sident 
of  the  lioard,  jihw^ieian  of  the  hos])ital,  and 
nianaL(er  and  eonsultin.sj;  jilu'sieian.  Definite 
teaehini.,^  fur  the  nurses  took  sha])e  in  iH;^, 
when  thrf)u.uh  the  intluence  <A'  '>r.  Mack  Miss 
.Mone\'  was  seat  to  l^n^land  tn  lirimj:  out  two 
trained  nurses  and  li\e  nr  six  jiroliationers.  A 
nurses'    home   was   ])lanned,   and    in    1S74  a  dcfi- 

1  Dr.  /akrzewska  is  the  author  of  an  interesting  bouk 
liast'ii  on  luT  oNpcricnces,  cntitlcci  1  I'ratial  UI:istratioii  of 
the  Rii^lit  of  \\',»iifii  lo  Labour.     C.  II.  Dail,  lioston.  iS6o. 


])( AilopiiKMit  of  Xursiii'^r  in  America  :,55 


niti' .>clu']iic  'it  iii^tnu'ti'in  ami  traiiiiiii^^  v.as  in  dji- 
t-ration.  Thr  liM.spital  was  called  St.  ('athmnr's 
(IriH'Val  aiitl  .Marine  ]ViS])ital.  Thr  mirsrs  wrvc 
rnniirt'(l  t<i  liiiid  tlHiusrhcs  in  srr\r  i'm;-  three 
years;  h'r  the  tirsl  six  jiiiiiuh.s  as  iiroliatii  Miers, 
without  reim...erati' 111,  ami  afterwards  with  a  sti- 
pend, board  (wlieii  not  eiii|)l(i\-ed  outside  "f  the 
h»)Si)ital:   the\-  were  evidenth-  .sent  to  ])ri\att.'  dutv 


er  to   othi'r    inst itutioii.'- 


atid  uiiitoniis: 


,vvrv 


woman  eiUerinL'  was  ix'ijtiired  to  Iirin!^^  satistaet<)r\- 
evidences  ol  ])virit_\'  of  luntix-e.  '^t>in\  eoiiduel  and 
character,  and  of  hax-itiL^  reeeiwd  llie  elements  of 
a  ]>lain  I'.n^L^lish  edueatinii. 
savs : 


he   re]  11  111   ot    iS-^ 
I'^very   possiMe  ojijjortunitx'   is   sc  ize(l   to 


impart   instruction    o 
toaehiiiL:  will  he  <Mve 


t    a    jiraetual    natinw    while 
n  in  elieniistrx-,  sanitar\-  sci- 


ence, popular  ])hysiol()nry  and  anatonu-,  h\\i:icne 
and  all  such  branch 


es  ol  the  hcalinur  art  as  a  nursi. 


ou 


'ht  tol 


>e  lainihar  wi 


th. 


'rotestant   sisterhoods  ha\-e  also  i)lavcd 


sonic 

])arl  in  the  early  nursing;-  histoi-\-  of  the  countr\-. 
The  tirst  iinjnilse  toward  the  formation  of  sister- 
hnods  within  the  Protestant  Kjiiscopal  church 
came  from  the  Rev.  Dr.  Muhlcnbcrj^-,  who  had 
visited  Kai;:'>rsw\'rth  and  had  become  I'lithusiastic 
over  its  sjjirit  and  .st'o])e  of  work.  Ih-  wrote  a 
pam]»hlet.  after  his  return  from  Crermany,  called 
the  lnstrnclio)i  e/  f )cacoucssrs  in  thr  Frani^clical 
was    largely  due   to   his  inlluencc 


Church,  and   it 

and  su^jTostions  that  the  creation  of  the  Sisterhood 

Ot  the    lloI_\-   Conniuuiioii,    the    first    iiiiiei>eudent 


oD 


S6 


A  1  li-^iory  oi  Nur.siii;^ 


(•r)niniiinit  \-  cf  I'ri  itr.sl.iiit  Sislrrs  of  ('liaritx'  in  the 
l/iiitci]  States,  was  succTSsfulh'  bniu.Ljht  almut  li\- 
thr  ]>astiir  of  the  chtnx'h  "I  ilu'  IImIv  ("omniun- 
ii)n  in  Xew  \'(irk  ("it\'.  The  sistciiiood  was 
('slal)lishc(l  in  1S45,  thns  beiiii,'  conicidont  with 
the  tirst  En,cjlish  sistcrlinoil ;  its  urbanisation,  how- 
ever, was  not  c()n"i])k'le(l  until  i(S5j.  The  Sisters 
tau,t,dit,  and  made  the  eare  of  the  siek  one  of  their 
objeets.  Tliey  s])ent  four  years  in  nursinj,^  the 
patients  of  the  intirniary  su]i]iorie(l  liy  the  ehurch 
of  the  lioh-  Communion,  and,  in  eomu'etion  with 
it.  opuied  a  dispensarA-  wliieh  has  keen  s])oken  nf 
as  the  beL;innin_i,'  of  the  ]iath  wlneli  led  lei  the 
founding  of  St.  Luke's  hospital;  the'i:,  v/hen  this 
hospital  was  opened  in  i85(;  under  the  aus])iees  of 
the  chureli,  the  Sisters  were  transferred  to  it  and 
remained  in  ehar;j:e  until  the  establishment  of  the 
seeular  nursin.L;  sehoi  1I  iri  1SS8. 

The  sisterhood  still  retains  man}'  fields  of  aetiv- 
it\',  and  professt's  the  eare  of  the  siek  as  a  chief 
interest.  The  ruk's  of  the  house,  with  the  excep- 
tion of  a  few  minor  details,  wi're  ada])ted  fnnn 
those  of  Kaiserswerth.  and  <  mv  ( >\  {hv  Sisters  of  the 
earlv  period  of  orijanisation  liad  t:[one  there  fer 
.some  trainin.t^f.  This  Sister,  as  superintendent  of  St. 
Luke's  hos|)ital  later,  was  acti\'e  in  the  movement 
to  pre])are  nurses  for  the  war  of  1861-64  by  takiiiL; 
them  into  the  ei\-il  hos])itals  t'or  a  short  and  hur- 
ried j)reparation  for  the  over\vhelmin<,'  exigencies 
of  militarvhospital  service.  ICxcellentr.ntldevoted 
work  in  this  <lireetion  was  also  carried  on  bv  a 


l)c\cl(),  ,ncnt  of  Nursiivjf  in  America 


03  / 


Prntostant  Sistrr  in  Haltimort',  Mrs.  Ailclinc  Tv- 
l(ir,  will  I  hail  also  hail  a  t'rrtain  anmunt  of  Iraiiiin.ij; 
at  KaiscrswiTth,  ami  \vhi),  as  the  hrail  nf  a  cdiv.- 
inunity  in  BaltinKtrc.  conductcil  two  larsj^c  \\ar 
hi>S])itals  in  Chester  and  Annapolis.' 

Wlien  the  a]>pallin,L:  (.uthurst  of  "ir.an's  inhu- 
manit>' to  man,"  thc(.~i\-il  War,  s\vr]it  like  a  .storm 
over  the  land.  o\'ershadi  iwin^,  for  the  time  1 -eini,', 
every  .sn:aller  and  less  cosmic  preoccupation,  it 
washed  a\\a\-  the  ])ettv  anchors  which  had  kejn 
the  majorit\-  of  women  carefully  moort'd  in  the 
quiet  ri'mote  little  l)a\'s  of  domestic  seelusinn,  and 
they  floated  out  u])iin  the  stream  n\  ]);ililie  duties. 
Ahhorrent  as  is  the  whole  idea  nf  war  tn  those  who 
see  in  nian  nobler  ])ossiiiilities  than  those  of  bt\asts 
of  jirey,  it  is  newrtheless  im])ossiMe  not  to  recoL,^- 
ni.se  the  immi'nse  opportmuties  for  n-irrani^ement 
of  social  orders  which  il  has  ,L:;i\-en;  and  in  the  ease 
of  wonn'U  it  is  a  strikin^^  fact  that  their  modern 
movement  toward  lei^'al  and  .social  freeiiom  re- 
ceived an  enormous  impet\is  from  the  dynamic 
forcesof  three  cj)och-makinL^wars.  Thus,  the  war  of 
Freedom  jjjave  the  women  nf  (iermain-  their  ojjin- 
inij  to  make  their  aliilit_\-  felt;  out  of  tlie  Crimean 
War  emer<;ed  the  fi.i^ure  of  I-dorence  Xii^htini^ale, 
whose  memory  and  iniluence  will  live  lon<a;  after  all 
themi]itar\-achicvemcntsof  that  time  are  forcfottcn; 
and  lastly,  the  Civil  War  marks  the  beL^dnnint,'  of 
all  oriranised  concentration  of  wmnen  in  this  coun- 
try in  public  duties. 

•  A  Century  of  X'jrsinf^,  cit. 


35'^ 


A  History  of  Xursin^- 


T<i  i,n\-c  rym  a  ])artial  fslimatt'  <<\  the  extent 
ami  cii]n])le.\itv  of  the  atYairs  ailniinistered  h,y 
\\ii!iieii  ihirini:  ihe  war  is  out  nf  the  (|uesti(>n,  aiiil 
rwu  tlie  wi^t  ])ri  i])eirti<)n  nf  the  eare  at  i\:v  sick 
and  \\(uinilr.l  eaii  he  tuiu'hei]  on  '  n\\y  in  barest 
outline.'  To  tell  the  .ste)r\-  <<l  that  war-time  nurs- 
iii!^'  is  out  of  our  ]xm-er.  Mueh  n\  it  will  i^robal^ly 
never  he  toM.  nnr  will  many  of  its  aetors  be  known 
to  y)osterily.  The  ener<,'\'an(l  ability  of  the  women 
were  expressed  through  the  Sanitary  Commission, 
and  this  body,  N.'Mch  took  the  j)laeo  occupied  to- 
day by  Red  Cross  orjjanisations,  received  its  first 
impulse  from  th('m.  for  its  historian  sa\-s:  "The 
earliest  movement  that  w;  rnaile  for  any  relief 
was  l;)egun,  it  is  hardly  necessary-  to  say,  bv 
the  women  of  the  country."-  Two  espcK-ially 
notable  fiirures  are  associated  witii  its  forma- 
tion: l>r.  l-^lizabeth  Ulackwell,  ])r(ibabh-  the 
most  commandint(  ])ersonality  amonjj;  our  pio- 
neer j)hysicians,  and  Miss  Louisa  Lee  Schuyler, 
whose  mind  was  worth\-  of  Ikt  jjjreat  ancestor 
Alexandi-r  Hamilton.  L)r.  BlackAvell  returned 
from  EnL,'land,  where  she  had  been  in  intimate  re- 
lation with  Miss  Xightini,'ale,  full  of  enthusiasm,  in 
1 86 1.     She  called  an  informal  meetinj;  of  women 


'  ll  is  istimatt'il  that  two  tliousiuid  womon  wore  ongani'd 
in  nursing;  .iml  linspit.il  ailministr.itinn  <lurins;  tho  Civil 
War. 

' //i.v/(if  I  .',  J.J,  I  i:iuii  ,'J(|,•.^  >aiiiii]ry  <  iiwiinssu^ii .  By 
Charles  J.  Stillc.  J.  B.  Lijuiiiuotl  and  Co.,  I'hilaildphia, 
i366. 


bcxclopmcnt  of  Xiirsin^^  in  Aimric;i  359 


loj^'L'lIu.T  at  llu'  Xi'W  \'()rk  lnlinnar\-  lor  \\'(inu'ii 
ami  ChiMivii.  which  she  luul  founded  some  sexen 
years  pre\-i(iu>I\-.  Thr\-  fonr.rd  the  hadies'  Cen- 
tral Relief  Coininittet',  and  drafted  a  Klter  eallin.t; 
fir  a  inass-nieetin,Lj;  at  C(.)oper  I'ni"  m.  and  there,  on 
A])ril  26,  1861,  the  proposed  Relief  As.soci;ition 
was  enthusiasticallv  endorsed  and  enlarjj^ed,  Miss 
Louisa  Sehu\ier  liein.i,^  lU'cled  president.  There 
had  hcon  some  even  earlier  stej)S  taken.  ( )n  the 
15th  of  Ai>ril,  tlk' da\- .111  whieh  llie  President's 
call  lor  troops  appeared,  the  women  of  Hridj.;eport, 
Cniinccticut,  and  tho.se  of  Ciiarleston.  South  Car- 
olina, had  ororanised  socicti(\s  to  provide  relief, 
inrsint,',  and  eomforts  for  the  volunteers,  and  a 
few  ('ays  afterwards  the  women  of  Lowell.  Massa- 
chusetts, had  done  the  same.  On  the  igth  of 
.\pril  the  women  of  Cleveland,  Ohio,  had  orj,'an- 
Md  with  the  purpose  of  assi.stinjj;  the  families  of 
Vdluntecrs. 

The  call  to  the  Cooper  Union  meetiu},'  was  a 
stirrinpj  doeument,  anrl  was  sijrne<l  hy  ninety-two 
v-'inen,  one  of  whom  was  Mrs.  Ciriflin.  later,  and 

>v  many  years,  the  president  of  the  Bellevue  train- 
■■'■•^  school  for  nurses.     The  preliminary  meetinj,' 

t  the  inhrmarv  hail  been  attende.l  hy  men  also, 

■ne  of  whom,  the  Rev.   Dr.   Bellows,  assisted  in 

:raniinf,'   the  constitution  which  was  adopted  for 

\hr  Women's  Central  Association  of  Relief,  and 

which  reciteil.  -imong  others,  as  its  ohjeets;   "To 

<\Uvt   and    di.sseminato   information    upon    the 

■Mil   an<l    prospex'tive   wants   of   the   army;  to 


300 


A  History  of  Nursing 


I'stalihsli  rcci)L,nu.st'(l  rclalions  wuh  tin-  ir.cilical 
statY  aiii]  t'l  act  as  an  auxiliary  li>  it;  to  maintain 
a  crnlral  ilr]"it  "1  slurcs  an^l  to  open  a  liiUTau  for 
the  fxaniinatii  m  anil  rej^nstration  i  if  nurses."  The 
first  i)\-rrturc'  made  \>\'  the  sociilx-  tn  the  military 
otVicials  met  with  a  scaxtc  rebuil.  and  Dr.  Bellows, 
the  (lelci^ate,  wa.s  so  convinced  by  the  sweeping 
statements  made  to  him  of  thi^  full  readiness  of  the 
army  medical  iU'])artment  for  a'l  emeri^encies 
(aj,'ain,  as  at  Scutari,  nothing,'  was  wantedj  that  he 
returned  ti>  the  womt'ii  and  '-epot-t  ',\  that  he  be- 
lieved tin  ir  c'ff'irts  were  imnecessary,  and  avouVJ 
onh'  apjiear  ti>  lie  foolish.  The  women,  however, 
disbelieved  this  statement  an<l  refusinj^  to  adopt 
this  view  continual  their  ])rei)arations.  Event.s 
soon  convinced  Dr.  Bellows  also  that  he  had  been 
too  optimistic. 

Mi.ss  SchuyU'r  and  In  r  clleai^Mies  early  realisofi 
the  jjij^antic  extent  of  the  task  bet'ure  thcTii.  and, 
largely  throu^^h  their  efforts,  the  Woman's  Cen- 
tral Ri'lief  Association  joined  with  the  Board  of 
Phvsicians  and  Surgeons  of  the  Ilosjiitals  of  Xew 
York  and  the  Medical  A.s.sociation  for  I'urnishing 
Hospital  Supj)lies  in  makini;  that  joint  appeal  to 
the  i 'resident  for  the  creation  of  a  national  oflicial 
commission  which  resulted  in  the  order  issued  liy 
the  Secretary  of  War  on  June  (),  1861,  creating 
the  body  which  was  known  as  the  Sanitary  Com- 
mission. Eight  men  of  eminence  and  absolute  in- 
tegrity were  n})i)ointed,  Dr.  Bellows  being  chosen 
prcsi<lent.      The    Woman's    Central    Association 


Dcxclopmcnt  of  Xursin^'-  in  America  361 

i>\   Relief  niAv  liecamc  a  lirancl;  of  the  Sanitrirv 
Cninmission,    and    co-ordinateil    all    of    ih^    ri'licf 
orjianisatioiis  tlironi^diout     'u'  eountn.-,   stimulat- 
ini,'  the  fdnnatinii  of  branelies  wJKrc  thc\-  did  not 
I'xist,  and  hrinj^nnLT  ^'H  into  one  harmonious  and 
ma^'iiifieent  system.'      Dr.  Rlaelnvcll  was  so  ham- 
[KTrd    by   masculine   jealous}-  in  all   she  tried  to 
do  at  that    time  that,  rather  than  jeojxirdise  the 
cause  to  ^vhie■h  her  licart  was  '/n'vn,  she  retired 
from  a  prominent  share  in  the  administrative  work 
nf  the  commission,  while  none  the  less  actively  en- 
jiaginjr  in  its  service.     The  prej)aration  of  women 
as  nurses  for  the  wounded  soldiers  absorbed   her 
ittcntion  for  a  time,  and,  in  co-operation  \\ith  a 
mimittee  of  Women,  .she  selected,  trained  (as  well 
as  the  pressure  of  the  emerj,'ency  would  allow), 
and  sent   to  the  front  about  one  hundred  nurses. 
In  her  own  bo.  .k  she  says  that    the    most  prom- 
isinijof  them  were  sent  to  Bellevue  Hospital  for  a 
month.-'      Dr.   P-laekw,  !!    had  loni,  been  deeply  in- 
terested in    the  (question   of   trainin.i,'  for    nurses, 
and    her  intimacy  with    Miss   Xi.uhtini^ale  must 
ha\e  accentuated  this  interest.    Her  influence  and 
knowledge  were  continuall}-  exerted  in  behalf  of 
Rnod  teachinji:  and  a  hij,'lK^  standard,  but  she  has 
Ixen  fo  mrxlest  and  unassuming  af)out  her  own 
\\'"rk  that  the  full  influence  of  her  ideas  in  the  final 


'  See  letter  from  Miss  Louisa  Schuyler  to  the  3,^5  Women's 
Hniuhes,  rH(/tJ  >7a/.i  Sanitary  Conntiissioti  by  Katherine 
I'  Uormeley,  Boston,  1863,  apiJcntli.x,  pp.  371-174. 

•  Op.  cit.,  p.  236. 


36- 


A  History  of  Nursing 


c\'()luli(iii  of  trained  nursini,''  will  ]K'rhai).s  iicnxT  lie 
(luitc  realised.  In  iS5()  she  and  lier  sister  Eni- 
ilv  had  prepared  a  statenu-nt  of  tlieir  aims  and 
intentions  for  the  W'W  \'ork  Infirniar\-  for  Women 
and  Children  whieh  had  been  ineori)oratrd  in  1854 
for  thrrr  ])urposes:  the  relief  of  the  siek  poor; 
tlu'  training:  <  <(  women  ])hysieians;  the  trainint^  of 
nurses.  In  their  statement  the  sistei's  said'  "In 
this  hos])ital  we  would  also  estalilish  a  svstem  of 
instruction  for  i-nir.ses, — its  ])lans  to  be  based  on 
those  drawn  up  by  Miss  Xi,L,duin}j;ale  for  her  pro- 
posed school  in  I.oTidon,  .  .  .  with  which,  thousjih 
newT  Vet  ])ublishi_  '  "'e  are  well  aci juainted."' 
Loul;  after  training  ..  ^ols  were  an  accomplished 
fact  a  friend  said  to  Dr.  Blackwell :  "Thee  ha.s 
had  so  much  to  do  with  the  reform  of  nursinj,',  I 
think  it  is  too  bad  thy  share  in  ii  has  not  had 
more  reerv^niition."  "  Wdiat  does  it  matter," 
she  ansv.ered.  "so  long  as  the  work  itself  is 
done?" 

The  work  of  the  Sanitary  Commission  is  jusliy 
cekbrated  as  a  magniticent  tx'eord  of  Innnanitarian 
Work.  Its  loaders  were  all  thoiou;,^hl\-  ac(iuainted 
wnh  the  sanitary  history  of  the  Crimean  campaijijn 
and  will)  .Miss  Xii(htin<j;ale's  work  (it  is  known, 
moreo\er,  that  they  had  her  counsel  and  advice), 
and  their  puri)<)se  from  the  outset  was  to  prevent 
uselcso  sutTerinj::  and  to  minimise  sickness  In-  hv- 


'  Medicine  as  a  i'tojisnou  Jor  W  oiiun.  Read  at  (.  iinion 
liall,  Di'c.  2,  iSjQ.  Put)lisIuM  by  Tinson,  New  York,  at  the 
request  of  the  tmsteesof  the  infirmary,  in  i860, 


Dcxclopmcnt  of  Nursinc;'  in  America  36^, 


iricnic  precautions.  (h\-in:4  t')  military  ()])position 
;iii<l  jealousy  '  they  were  not  always  a!)le  to  carrA- 
out  llu'ir  ])lan,s  {d;-  i)n'wnti(in,  thou.i^'h  tlu'se  were 
always  made  with  f;ir-si,!^'ht(,'(l  wisdom,  l-'or  the 
care  of  the  sick  and  wounded  soldiers,  an  admi- 
rable .system  of  hospitals  was  eventually  de\-el(  ijx'd 
under  its  fosterin<x  control,  and  thou!.(h  the  nursing,' 
had  a  thnr'iuLjhly  amateur  character  throu.^hnnt 
the  war,  it  was  carried  nii  with  unselfish  ilevotion, 
and  many  of  the  nurses,  sell-tau.^ht  and  disciplined 
l.vdire  necessity,  attained  a  hijj:h  des^ree  of  practi- 

al  skill.  Thi'  most  defimti'  landmark  in  the  some- 
what formless  nursini;  department  of  the  Civil  War 

•  as  the  official  apjxontment  of  Dorothea  Dix  as 
S'lperintendent  of  .Nurses.  This  remarkable  wo- 
man, the  female  Howard  of  this  country,  is  too 
.seldom  remembered  by  the  present  .generation. 

Dorothea  Lynde  Di.x  was  born  in  Maine  in  1S02. 
lu  18,^6,  \\h;le  traw'.lniLf  for  her  health,  she  visited 
the  family  of  Mr.  k.ithbone  in  Li\ crp, ,, ,].  the 
tather   of   Wurkhouse    i!itirmar\-    nursing;    reform 

'  Their  jilaiis  were  looked  u])on  ;is  a  deep-laid  scheme  for 

me  selti  !i  i)un)oses,  and  the  Steretary  of  War  at  first  asked 

Ihf  delegates  to  state  frankly  i)reeisely  what  they  wanted, 

since  it  was  evident  they  could  not  want  only  what  they 

'tiled  to  bo  .isking  for.     The  history  mentioned  says:  "ft 

■niliatmK  to  record  the  utter  inability  on  the  part  of  our 

t  .\iiieriean  officials  to' a!>i)rcciate  the  best-considered 

!  most  widely  extended  system  of  mitigating  the  horrors 

■var  known  in  histor>-,  and  esj-eeially  at  a  time  when  the 

■•.nee  of   the  government  was  dependent  upon  the  health 

i    thciency  -f  that  army,  which  the  appointment  of  a  sani- 

^ry  commission  was  designed  to  promote."     S  ill<<    ot,  cit 
p.  60.  '     '  ■      ■' 


■.'! 


:/)4 


A  Il!>tor\-  of  Xursiii!. 


anil  in   1S41  slv^  lx\L;an  tearhinL,^  in  the  prisons  0 
luT  native  State.     1  ler  allention  was  drawn  to  thi 
condition  of  the   insane.  w'Meh  was  then  'iiiite  a; 
horrible,  in  almost  all  ])arts  of  the  country,  as  ir 
the  (lays  of  Howard.   She  determined  to  investii.,fat( 
it  and  for  two  yeans  made  a  most  searching  per- 
sonal  examination   of  every  alm.shou.se  and    jail 
(where  the   insane  were    then    confined)  in    Ma.s- 
sachusetts.     Like     Howard,    she    kejit    an    exact 
record  of  every  fact,  and  when,  at  the  cm]  of  her 
investi<>;ations,  she   memorialised   the  Le,i,nslaturc 
of  Massachusetts,  her  testimony  of  what  she  had 
.seen  was  appallini^j  and  irrefutable.      Her  earliest 
.supporters  were  Dr.  S.  (i.  Howe  and  Charles  Suin- 
ntT,  and  the  result  of  her  work  in  .Ma.ssachusetts 
was  the  immediate  extension  of  State  care  for  the 
ins;ine.     For  the  next  twenty  years,  in  everv  state 
of  the  Union  (and  that  was  in  the  davs  of  rou,>:h 
travel),  she  carried  on  the  same  elosi-  unfaltering 
inspection  and  record-makini,',  and  took  her  accu- 
sations  and    appeals  into  every  Lc.arislaturc.     As 
no  State  hospitals   then  existed,  she  became  con- 
vinced of  the  necessity  of  applying  the  principle 
of  taxation  to  this  purpose,  and  the  creation  of 
State  hospitals  in  many  states  was  the  direct  result 
of   her  conceptions  and    resolution.     New  Jersey 
was  the  fielil  of  her  first  victory  in  this  great  piece 
of   constructive    statesmanship,    in    1845. 

After  her  wonderful  campaign  in  the  states  she 
concci\e(l  the  projcx:t  of  persuading  Con^  ress  to  set 
aside  twelve  million  acres  of  the  ])ublic  domain 


I)c\tl()j)mcnt  of  Xiirsin-  in  Anicrif.i  .^35 

■nv  the  fiKlMWinctit  Ml"  inoitui  ions  f,  ,r  tiic  insane, 
;'i'  i'lind,  ami  oihcr  lul])K'ss  nicnihcrs  of  .socict_\-, 
,  •  ':  -.lu'  artiKiIl\-  jiushn!  this  -i;_,'anli<'  nml.Ttakin.L,' 
.^iKvc'Sstull_\-  throu,L,fh  IioUi  houses  of  CoiiL,r,x.,ss,  and 
saw  her  ideal  about  to  he  realised,  onl\-  to  Ik-  fairly 
(Tu:;he(l  by  a  disappointment  totally  unexpeeted, 
IT  ihe  Pre:  ident,  iM-ankliii  Pierce,  small  of  ealihre 
,i:i'i  niedioere  of  mind,  had  the  p'.wer  to  undo  and 
I)i\\-ent  great  thinjrs  whieh  he  was  not  capable  of 
>.;vatin<x,  and  he  \-etoed  the  bill. 

.Miss  Dix  afterward  travelled  abroad  and  carried 
on  investigations  into  the  conditifni  of  the  insane 
in  a  numl)er  of  foni_L,m  countries.  1  Icr  ap])oint- 
mciit  to  the  superintendene\-  of  tht'  war  ntu-sini,' 
was  in  recognition  of  her  vast  public  services,  but 
she  was  then  nearly  sixty  years  old,  worn  from  her 
exhausting  life-work,  and  could  not  ackqit  herself 
to  the  general  conditions  of  a  ho.spital  service. 
She  herself  .said  that  this  was  not  the  part  of 
her  life  bv  whieh  she  wished  to  lie  iudged.  Ihr 
standards  were  high  and  inflexible,  and  she  antag- 
onised many  of  those  with  whom  she  was  obliged 
to  Work,     vSht<  died  m  1887.' 

'  See  Life  of  Dorothea  Lytidr  Dix,  l>y  Francis  TilT.inv 
H  nif,'liton,  Mitllin  &  To  ,  Boston,  1S96. 

( ircular  Xo.  7,  is.sued  from  tho  Surjieon-Cicncrals  oiiict-  in 

•'!t^'\Var  Department,  read:     "In  order  to  give  greater  ulil- 

•V  '■•  the  acts  of  Miss  Dorothy  L.  Di.x  as  sui)erintendent  of 

■men  nurses  in  general  hosi)itals,  and  to  make  the  emi)loy- 

■  "ont  of  such  nurses  confonn  more  closely  to  existing  laws, 
...     Miss  Dix  has    been  entrusted   hy  the  War  Depart- 

■  'It  with  the  duty  of  selecting  women  nurses  and  assigning 
■'nil  to  general  or  iierniaiKiU  military  ho.spitals.     Women 


366 


A  I  li^tory  of  Xursing 


The  iiii'dicil  |)rMU'>.si')ii  (Irst  went  on  reronl  in 
iVLjai'i!  til  imrsiiiL,'  rfforni  in  Ma\-,  iSrxj,  whrii,  at 
Ihr  \'{>w  Oi-lcaiis  nicftiii,^;  of  tlh'  American  Medical 
AssDciatiiin,  a  report  of  a  Committee  on  tlie  Train- 
ini^f  of  Xurses,  \vlio-;e  chairman  was  Dr.  Samud 
Gross,  was  presentol  to  the  meetini:;.  The  com- 
mittee was  a  sjH'cial  one,  apjiointdl  to  inf|uirc  into 
tlie  best  method  of  or^ranisint^  and  conducting,' 
institutions  for  the  trair.ini^^  of  nur-is,  and  some 
of  its  concUisions  aie  of  much  interest.  The  report 
recited  the  stranije  nej;lect  of  nursiiiL^  in  the  United 
Stales;  thr  loiiL^-felt  need  of  ^ood  nursin^L,^  nieii- 
tii..H'(l  the  fact  that  the  Cathohc  orders  were  the 
only  ones  who  seemi'd  to  n  ihse  its  importance; 
ami  said;  "  It  is  perhaps  for':unate  that  the  mor- 
tality occasioned  hy  bad  n-nsint:;  cannot  l>e  esti- 

nurses  are  not  to  be  cniiiloycd  in  sueh  hospitals  without 
her  sanction  and  apprmal  ex-'ept  in  case  of  urgent 
tU'i'd. 

Women  nurses  will  be  under  the  control  and  direction  of 
the  medical  officer  in  charge  of  the  hospital  to  which  they  are 
assigned,  and  may  be  discharged  by  him  if  incompetent,  in- 
subordinate, or  otherwise  unfit  for  their  vocation.  Miss  Dix  is 
charged  with  diligent  oversight  of  women  nurses,  and  with 
the  duty  of  ascertaining  by  person.il  inspection  whether  or  not 
they  are  properly  performing  their  duties,  and  medical  ofiiccrs 
are  enjoinerl  to  receive  her  sug.gestions  and  counsel  wUh 
respect  and  to  carry  these  into  ctTei-L  if  compatible  with  the 
hospital  service. 

.•\s  it  will  lie  impossible  for  Miss  Dix  to  supervise  in  person 
all  the  military  hospitals  she  is  authorised  to  delegate  her 
authority.   .   .   . 

Women  wishing  employment  as  nurses  must  apply  to  Miss 
Dix  or  to  her  authorised  .igents.  Army  regulations  allow  one 
nurse  to  every  ten  patients  (ticds).     As  it  is  the  exi)resse(l 


Dcxclojirncnt  of  Nursing  in  America  367 


niatcf]  l-A-  tliDse  mnst  immorliatclv  affected  by  it 
as  a  knowlcl^c  of  it  wr)ul(l  entail  upon  theni  an 
immense  amount  of  misery  an<l  mental  an,L,ri,ish. 
X-irsiiii^r  in  its  more  exaet  sense  is  as  much  Of  an 
art  and  a  science  as  medicine." 

Then  followed  some  statistical  description  of  all 
the  rxistm-  JYotestant  institutions  in  the  Old 
Wwrld.  l.e-innin.L^r-.vitl]  Kaiserswerth.  and  inclu<lin,i,r 
all  the  London  hospitals  refonned  up  to  that 
time.  The  R'port  mentioned  the  earlv  American 
off.irts  and.  the  vast  extent  of  ^•r,!unteer  nurs- 
m  of  the  (hxil  War,  and  made  the  folluwin.t^r 
rc.'omnu'ndations: 

r.  That  c\-ery  lar.crc  and  \veli-orijaniso(l  ho.spital 
should  have  a  sch(K,l  f..r  the  trainin,!,'  of  nurses,  not 

-;ily  for  the  supply  uf  its  <Avn  ncL'cssities,  but  Iit  pri- 

^v.Il  wf  the  -rn-crnnicnt  that  a  portion  r.f  these  nurses  shall  be 
"•■•nu-n.  and  as  Congress  has  giv.n  to  the  Surgeon-General 
authority  to  deoide  in  what  number  women  shall  be  substi- 
tuted for  men,  it  is  ordered  that  then,  shrd!  be  one  woman 
nurse  to  two  men  nurses.  Medical  o'heers  are  hereby  re- 
quired to  organise  their  respeet.ve  hospitals  accordinglv. 
AK.iKal  officers  requiring  nurses  will  apply  to  Miss  Dix  or  her 
■'iuthonsed  agentj. 

Sisters  of  Charity  will  continue  to  be  employed  as  at  iiresent 
un^er  special  instructions  from  this  otl.ce.     Signed    \Vm     \ 
H..>,iinond.  Surg.-Gen.     Miss  Di.x's  requirements  for   candi- 
tlaa-s  were  specified  in  the  ne.xt  order,  Circular  No.    S,  July  ,4. 

>-'J  candidate  for  position  as  nurse  was  to  be  considered 
unkss  she  was  between  the  ages  of  .,5  and  50.  Matronly  per- 
«.i^  of  experience  an.l  those  of  superior  education  and  s.nous 
dnpoMtion  were  to  have  the  preference.  Habits  of  neatness 
•ina  ..rder,  sobriety  and  industry  were  essential 


30S 


A  History  of  Xursini( 


vate  familifs;  the  toacliint^  to  !)e  fiirnishcd  liy  its  uwn 
medical  staff,  assisted  by  the  resideiu  phvsicians. 

II.  That,  while  it  is  not  at  all  essential  to  combine 
relijjious  exercises  witli  nursin.L,',  it  is  believed  that 
such  a  union  wouM  he  eminently  conducive  to  the 
welfare  of  the  sick  in  all  ])ul)Iic  institutinns,  and  the 
committee  therefore  earnestly  recommend  the  estab- 
lishment of  nurses'  homes,  to  be  placed  under  the  im- 
mediate sujiervision  and  direction  of  Deaconesses  or 
lady  superintendents. 

III.  Tliat,  in  order  to  j^nve  thcjrotit^di  sco])e  and 
etticieney  to  this  scheme,  district  schools  should  be 
formeil  and  placed  under  tiie  guardianship  of  the 
county  meilical  societies  of  every  State  and  Territory 
in  the  Union,  the  members  of  which  sliould  make  it 
their  business  to  imjjart  instruction  in  the  art  and 
science  of  nursing,  including  the  elements  of  hygiene 
and  every  other  species  of  information  necessary  to 
qualify  the  student  for  the  important  duties  of  the 
nurse. 

The  committee  further  suggested  the  impor- 
tance of  forming,  in  every  ccjnvenient  place,  socie- 
ties of  nurses  who  should  ha\-e  tiie  preference  in 
calls  over  the  uneducated  attendants.  This  recom- 
mendation is  an  exceed iiiL^lv  interesting  one,  and 
well  wiirtlu'  of  note  as  original,  since  it  fcjreshad- 
owed  the  actual  developments  of  later  years. 
The  report  concluded  with  a  summary  of  the  (qual- 
ities necessary  for  the  nurse  io  possess,  taken, 
apparently,  though  withi^it  acknowledgment, 
from  the  regulations  of  the  Nightingale  school, 
and  it  was  res(jlved  that  a  copy  of  the  rep(jrt  should 


1Jl\  clupnicnt  of  Nursing  in  America  369 

l>c    sent     to     medical     societies     all     over     the 
ciiuntrv.' 


'Proceeding's  of  the  Amcruan  Medical  Asaociatiou  \cnv 
Orleans,  May  .869.  Repnnt,  Med.  Ncies.  Philadelphia, 
ISO.;,  vol.  X.X.,  pp.  35,,,  35  , .  In  November  of  this  .same  year 
the  celebrated  scientist  Virchuw  gave  similar  recommenda- 
tions to  an  association  of  women  in  Berlin,  Germany. 

vol..  II. — 24. 


CIIAPTl-R  IX 


A   TRIO  OF  •rRAIMXr,   SCH(M)I.S 


TI 1 1'2  war  came  to  an  end,  hut  the  splendid  Avork 
of  the  women  uu  thr  Sa.nitary  Commission 
and  of  the  nursr.-.  in  the  lirld  eould  not  die  away; 
thL'ir  aroused  encr<,nes  could  m  >t  be  stilietl,  n(  »r  their 
lields  of  acti\-ity  be  again  restricted.  When  they 
returned  from  mihtary  service  it  was  to  take  up 
with  moral  courage  and  determinatii  ai  a  new  cair- 
paign  for  the  reforniatinn  of  ci\il  institui  ions. 
The  establishment  of  trained  nursirig  in  America 
came  as  the  result  t)f  the  war  almost  as  directly  as 
it  had  o.nie  in  England.  Tlicrc,  Mis.s  'srhtingale 
turneil  from  one  work  straight  to  the  other;  here, 
the  Women  whi  >  were  to  be  the  future  managers  of 
training  schools  had  their  ])reliniinarv  training  in 
the  relief  service.  The  lirsi  three  schools  for  nurses 
established  after  the  war,  those  from  which  the 
steady  march  of  nursing  progress  in  America  dates, 
arc  monuments  to  the  creative  energy  of  organised 
women  who  ha /i  learned  their  power.  Two,  at  least, 
of  them  were  the  work  of  women's  committees, 
originating  with  them  and  not  with  hospital  gov- 
ernors or  medical  boards,  and  pushed   through  in 

370 


A  Trio  ofTniinin;^^  Schools       371 


iiitc  of  ()i)])(jsili()ii,  (loulits,  and  flisappnn'al  from 
,:.     (luartrrs.     One  ami  the  same  year  saw  this 

irinof  sc'iiools  I'StalilisliL'd  wilhin  tlic  wards  of 
iiiiportant  j^'eneral  hosjiilals:  lU'llexaic,  opLiicd  on 
May  I,  the  New  Haven,  on  October  i,  and  the 
Massachusetts  General  on  Xo\ember  i.  187:5. 

In  Xew  York  State,  with  its  large  population  of 
dependents  of  all  kinds,  herded  together  in  bar- 
rack-like institutions  under  the  general  super\-ision 
nf  the  State  Comniissicners  of  Charit\',  there 
was  not  a  woman  of  enUghtened  intelligence  or 
'Vlinement  in  any  position  of  authority  or  even  of 

:ispection.  Miss  Lijuisa  S(diu}der,  who  had  na- 
tionalised the  work  of  the  Saiiitar)-  Commission, 
and  whose  insight  grasped  the  whole  problem, 
'ir^aniseil  the  State  Charities  Aid  Association  of 
Xcw  York  State,  to  act  as  a  \-olunteer,  uiqxiid 
body  oi  citizens  for  the  improvement  of  the  public 
institutions  of  charit\-.  Its  form  of  association 
■>v;.s  completed  on  the  11th  of  May,  1S72,  and  Miss 
Schuyler  was  elected  the  first  president.     It  di- 

idcd  itself  into  three  dejiartments  for  iiu'cstiga- 
tinn  and  active  work,  dealing  v.itli:  I — Children. 
II  Adult  and  Able-Hndied  Paupers.  IIT-The 
^  ■■  in  lIos])itals.  The  association  com])rised 
i'^aii  men  and  women,  u]«)n  a  broad  humanitarian 
platform,  and  Mi.ss  Schuyler's  early  repcjrts  and 
papers  arc  excellent  examples  of  a  union  of  noble 
l)urj)osc  with  inteileetual  and  practical  ability. 
In  lirr  first  annual  rejMrt,  presented  to  the  C(jm- 
niiisioners  of  Charit>-,she  said,  among  cjther  things, 


CHAl'TI-R  IX 


A   TRIO  OI'    IKAIXIXC,   SCHOOLS 


TI 1 E  war  canu' lo  an  end,  but  the  splendid  work 
of  the  women  on  the   Sa.nitary   Commission 
and  of  tlie  nurses  in  the  lield  eould  not  die  away; 
tliei."  aroused  cner<,nes  could  n(  it  be  stilled,  nor  their 
lields  of  activity  be  again  restricted.     When  they 
returned  from  military  service  it  was  to  take  up 
with  moral  courage  and  detentiinatii  in  a  new  cani- 
])aign    for    the    reformation    of   ci\il    institu! 'ons. 
The  establishment  of  trained  nursing  in  America 
came  as  the  result  of  the  war  almost  as  directly  as 
it  had  uutie  in  England.     There,  Mis:,      'frhtingale 
turned  from  one  work  straight  to  the  other;  here, 
the  women  wht)  wert'  to  lir  tlie  future  managers  of 
training  schools  had  their  jireliminarv  training  in 
the  relief  service.    The  iirst  three  schools  for  nurses 
established  after  the  war,  those  from  which  the 
steady  march  of  nursing  progress  in  America  daces, 
are  monuments  to  the  creative  encrgv  of  organised 
women  who  had  learned  their  ])ower.  Two.  at  least, 
of   them   were  the  work  of  women's  committees, 
originating  with  them  and  not  with  hospital  gov- 
ernors or  medical  boards,  and  pushed   through  in 

370 


A  Trio  ofTrainini,^  Schools        371 


,s])ilc  nf  opposition,  doulits,  and  rlisapproval  from 
n..iny  quarters.  One  and  tlu'  same  year  saw  this 
iri'i  of  schools  eslalilished  witliiii  the  wards  of 
important  1,'eneral  hospitals:  Hellexnc,  opLncij  on 
.May  I,  the  New  Ihn-en,  on  October  i,  and  the 
Massaehu.setts  General  (jn  Xo\-ember  i,  187,^. 

In  Xew  York  State,  with  its  larj^e  populatir)n  of 
dependents  of  all  kinds,  herded  toi^'ether  in  bar- 
rack-like institutions  under  the  i^^eiieral  super\-ision 
'if    the  State    Comniissicners   of    Charit\-,    there 
was  not  a  woman  of  enhghtened  intelligence  or 
refinement  in  any  position  of  authority  or  even  of 
inspection.     Miss  L<niisa  Schuyler,  who  had  na- 
tionalised the  work  of  the  Sanitary  Commission, 
and  whose   insight  grasped    the   whole   problem, 
'irL^anised  the  State  Charities  Aid  Association  of 
.\'ew  York  State,  to  act  as  a  \-olunteer,  unpaid 
body  01  citizens  for  the  improvement  of  the  public 
institutions  of  charitw     Its  form  of  association 
■.vas  completed  on  tlu-  i  ith  of  Muv,  1S72,  and  Miss 
Schuyler  was  elected   the  lirst  president.      It  di- 
vided itselt  into  three  (icpartments  for  in\-estiga- 
ti'>n  and  active  work,  dealing  with:  I — Children. 
II  -Adult  and   Ablr-Hodied  Paupers.      III-The 
Sick    in    Ilo.spitals.     The    association    comprised 
lj<jth  men  and  women,  uj)on  a  broad  humanitarian 
platform,  and   Miss  Schuyler's  early  reports  and 
i)apers  are  excellent  examples  of  a  union  of  noble 
piirpo.se   with    intellectual    and    practical    ability. 
In  her  first  annual  re])Mrt.  ])resented  to  the  C(jm- 
miisioners  of  Chantwslie  said,  among  other  things, 


.w 


A  I  ii^lory  of  Niir.sinj^ 


in  s|H'aking  ol  the  visitors  to  the  institutions,  that 
they 

represent  the  best  class  of  our  citizens  as  rej^'anls  eii- 
I  <,'htei.'>d  views,  wise  benevolence,  experience,  wcaUh, 
influence,  and  social  positi(jn.  .  .  .  Ours  is  neither 
exclusively  man's  wor''  nor  woman's  work.  We  are 
men  and  women  working,'  tojjcther,  supplementing 
each  other's  powers.  .  .  . 

You  will  sec  that  we  have  aimed  to  place  our  W(jrk 
upcjn  a  foundation  as  broad  as  that  upon  which  our 
(jwn  republican  fnrni  of  jjovemmcnt  rests:  to  do  awa 
with  all  distinctions  of  race  or  sex,  of  political  parti- 
sanship and  sectarian  i)reju(liee;  to  have  the  work 
jud^'ed  by  its  merits  alone,  whether  it  is  or  is  not 
worthy  of  supi)ort  from  our  citizens.' 

The  Hospitals  Committee  bej.(an  work  at  <ii  ci 
ami  'Iclined  its  (h'ties  as  folbiws: 

I.  Tm  inform  itself  of  tlie  number  and  present  con- 
dition of  sick,  inebriate,  insane,  blind,  deaf-and-dui.ih. 
idiot,' and  a^'ed  jiaupers  in  the  Xew  York  State  institu 
tions  of  public  charities,  and  to  urjje  the  adoption  oi 
such  measures  as  are  best  ada{)ted  to  restore  the 
liealth,  alleviate  the  sufferings,  secure  the  humane 
care  and  comfort,  and  contribute  t(j  the  happiness  ot 
these  aflhcted  and  a>,'ed  peojile. 

II.  To  collect  and  impart  information  in  rej,'ard 
to  the  latest  and  most  ajjprovcd  plans  for  the  con- 
struction, ventilatifm  and  disinfection  of  hospitals  ami 
asylums;  to  prepare  plans  of  orj;anisation  for  their 
kitchens,  linen,  laundry,  an<l  nursinj;  departments; 
and     I'l    ac(iuaint     them.selves    with    such    hypenic 

'  First  Annual  Report  S  f  .\   A  .  187,; 


A  Trio  of  Training  Schools        373 


;.n  i  sanitary  regulations  as  are  in  accordance 
with  the  most  advanced  views  of  the  medical 
!  ri/fcssion. 

The   first  section  of  liie   Hospitals  Committee 

|>Ii<'inted  to  a  definite  institution  was  formed  on 
Jan.  (;,  1872,  to  visit  the  Westchester  poorhouse. 
Il  consisted  of  forty-nine  members.  Its  experi- 
oke  was  so  strikinj^rjy  like  that  of  the  early  Enjr. 
lish  .ij;rou]is  under  Miss  'I\vining  and  Miss  Cobhc 

■uit  it  is  well  to  record  it.  So  lonsr  as  the  ladies 
were  contented  to  work  themsel\-es.  and  to  make 
m.  criticism  on  the  manai,'cment,  everythini,'  went 
smoothly.     With  the  full  knowledjj^e  of  the  super- 

:tendents  of  the  poor  they  came  and  went,  con- 
•liieted  sewing  schools,  carried  delicacies  for  the 
.sick,  and  cared  j,'cnerally  for  their  comfort.  Hut 
the  ladies  became  aware  of  many  things  demand- 
ing immcfliate  reform:  there  was  an  absence  of 
classification   which  led    to   gross   itTinK)rality,  a 

mt  of  enlightened  treatment  for  the  insane,  no 
nursing  for  the  sick,  the  children  were  badly  fed, 
I'-ully  clothed,  badly  taken  care  of.  and  ex|x«ed  to 
(he  degrading  influence  of  the  atJult  i^aupers  in 
Hiarge  of  them.     The  ladies  otTered.  through  the 

'iiMrcn's  Aid  Society,   to  place  the  little  ones 

,i;"od  homes;  the  superintendents  of  the  poor 

alused,  wanting  then  to  remain  in  the  county 

where  they  could  h  k )k  after  them .     The  cone  1  it i(  )n 

"f  the  sick  was  cptvially  pitiable.     "  It  is  no  ex- 

k'tration  to  sr.y  that  in  most  of  our  countv  poor- 
hmises  no  nursing  of  the  sick  is  ever  attempted. 


,■>/• 


A  111 


i(irv  of  \ursini( 


Usualh-  thf  \-cry  ill  patients  are  cared  for  b  •  those 
ill  till'  same  room  who  are  less  ill.   .  .   .   Maiiv  pa- 
tients Were  in  the  last  stages  of  pulnKjnary  tuber- 
culosis; in  one  ward  there  were  several  cases  of 
paralysis,  e])ile])sy,  one  j^unshot  wound,  accident 
cases,  amputation,  etc."     In  one  ward  the  ladies 
found  a  terrihk'  case  of  sufTering  from  carcinoma 
of  the  face,  and  one  poor  man  crushed  }>\  a  steam 
shovel  and  in  great  agony.      They  asked  the  su- 
]X'rintendcnts  to  employ  some  one  t(j  nurse  the.sc 
sufferers;  their  request  was  refused  on  the  ground 
that  there  was  no  appropriation  of  funds  for  such 
expenses.     They  then  begged  to  be  ;dlowed  to  pay 
the  wages  of  a  ccjmpetcnt  nurse,  to  be  selected  and 
controlled  by  the  superintendent.      This  was  also 
refused.     "  Thi'v  could  not,"  said  the  women  in 
their  report,  "refuse  the  kindness  which  death  at 
last   brought  the  sufferers."     WIkii  the  visitors' 
suggestions   for   improvements   were   first   made, 
they  were  received  with  civility,  but  no  action  was 
taken.     Later  they  were  requested  to  come  only 
on  one  day  in  the  week.     Finally,  when  the  visi- 
tors repeated  their  ]X'titi(Mi  for  better  care  of  th 
children,  atid  for  a  nurse  for  the  sick,  olTcring  to 
I)ay  the  wages  of  such  attendants  until  the  Roan! 
of  Supervisors  met,  the  siqu'rintcndcnts  told  them 
that  they  had  no  authority  to  interfere,  that  il 
was  desired  that  they  should  no  longer  come  a> 
members  of  an  association;  the)-  might  come  as 
ordinary  visitors,  but  the  superintendents  person- 
allv  desired  to  have  no  further  intercourse  with 


A  Tr 


o  of  Trainini^  Schools 


375 


LiKin.  Not  lun.;;  after  +'-s  they  ^vcre  refused 
admittance.' 

A  i)erfect  exami)le,  this,  of  the  reasons  why  male 
oflieials  do  n(jt  want  women  interferinj,^  in  ttu-ir 
Inisiness.  But  in  time,  with  persistent  effort,  re- 
forms were  set  in  motion. - 

The  second  section,  formed  on  Jan.  26,   1872, 

'  First  Annual  Report  S.  C.  A.  A.,  1873. 

■  The  Statu  Charities  Aid  Association  stoo<l  upon  the  prin- 
^•iile  that  the  taxiiaycrs,  si:>p()rtinj,'  as  they  did  all  of  the  jiub- 
lic  institutions  and  all  of  the  ollicials  ai)]K)inted  to  administer 
the:n,  had  an  unquestionable  ri)^'ht  to  inspect  these  institu- 
tions and  to  see  how  they  were  managed.     After  their  \  isitors 
were  turned  out  of  the  Westchester  i>oorhouse,  the  S.  C.  A.  A., 
•'...iiidin!,',  as  it  did.  numbers  of  imblic-sjiirited  men,  secured 
jislative  enactment   larj^'ely  increasing  the  ])owers  of   the 
it>'  Hoard  of  Charities  in  the  matter  of  visiting,  and  then  by 
..rsun.il  agreement  with  the  board  it  was  arranged  that  the 
latter  should  appoint  as  its  onicial  visitors  members   of  the 
I'.int.iiy  .society  upon   the  recommendation  of  the  latter. 
;^  ..rrangement  lasted  for  eight  years,  during  which  time 
t  iindations  of  reforms  of  the  most  far-reaching  character 
:v  l.ii.l.     The  perennial  struggle  against   political  corrup- 
a  and  misnianagemeni  of  public  char!     ..le  funds  then  be- 
ne too  heavy  a  strain  on  the  moral  courage  of  the  board. 
• --•  tried  to  suppress  the  reports  made  by  the  visitors  to 
C.  A.  .\.,  and  so  to  the  public,  and  finding  that  this 
.m  was  resisted  it  broke  oil  the  relationshiji  with  the 
cr  body.     The  S.  C.  A.  A  ,  strong  in  the  support  of 
•«ncd  public  o|iinion,  then  asked  for  legislative  aulhor- 
■  continue  its  insi)ection  o'  institutions  and  was  actively 
"-■cd  by  the  board,  but  finally  secured  the  recognition  it 
"i      Si-e  .l(/./r,js  />(»«»  //),•  .V.  C.  A   A    to  its  Local  Visiting 
-itfivs  throughout   the   State  of    Wzu    York,  July,   1880 
t  of  publications)      .Also  Nos,  as  and  26.  containing 
'  lioate's  argument  before  the  Legisl.iturc  and   the  final 
rr  (if  the  S])ecial  tomniitli.  m  .  tiarc'  ..f  tb.'  l.i!l,  June  io> 


37C-> 


\  1  listory  of  Nursini;- 


was  llv.  Ikik'N'uc  Hcjspital  \'isitin,i^r  Comniillce 
consistinj,'  of  fifty-three  members.  Tlic  ladie: 
composinjj;  it  were  ealUd  to.irether  at  the  invitatior 
of  Miss  Louisa  Schinler.  "Several  of  them  hac 
been  mcmluTS  of  the  Sanitary  Commission,  am 
had  haci  experience  of  hospital  work,  but  the  ma 
jority  had  no  knowledj,^'  of  the  difticulties  of  tht 
task  before  them,  and  accepted  it  with  all  the 
bravery  of  it,morance.">  ( )f  these  ladies,  sek^^ted 
as  the>-  Were,  with  care  as  jjossessing  every  possi- 
l)le  ccjuipment  of  ability,  character,  and  social 
l)i)sition,  many  since  that  time  have  had  a  con- 
si)ieuoush-  imj)ortant  and  useful  carcei  in  tht 
civic  and  charitable  reforms  of  the  city  and  have 
been  identified  with  the  whole  movement  of  hos- 
])ital  and  nursinjj;  advance.  They  now  be.i^'an 
their  work,  every  member  takinjr  certain  days  on 
which  to  visit  certain  wards.  The  chairman,  Mrs. 
Jo.seph  Hob.son.  was  a  youni:,'  married  woman,  un- 
familiar with  poverty,  sickness,  or  dej^radation, 
and  who  ha<l  never  been  in  a  hospital.  On  her 
first  visit  to  Bellevue  she  wandered  bewildered 
through  the  lon^'  corridors  and  the  series  of  dou- 
ble wards  openini:;  out  of  one  another,  wondering 
how  to  bcjijin.  A  sort  of  external  cleanliness  and 
order  prevailed,  yet  she  felt  instinctively  that 
things  were  not  rijjht  somewhere.  As  she  ex- 
plored the  rather  deserted-lookini,'  extent  of  one 


'  History    o;    the    }ist,ibli.sliitu'nt    p;    the   lullciiii-   Training 
School   jor   Xnrsis,   read   at   the  Waldorf-Astoria,  March  6, 


A  Trio  of  Tniinin^  Schools        2>n 


li  "ir.  she  came  upon  a  ynunjr  man,  who  apjx\'ircd 
tn  lie  a  jjhysician.  and  who  was  busifd  about  some 
nf  the  j)atients.  Witli  some  eml)arrassnient  she 
w.  ;it  up  to  him  and  iiUnnhieed  herseU'  as  an  otli- 
r;:il  \-isitor,  and  said  she  would  lie  j^rateful  \'  ir  a  W\\ 
hints  as  to  what  to  look  into.  "  Vou  want  to  see 
thiiii^s?"  said  the  youn<r  m-.n  with  an  inexphcable 
expression;  "well,  I  can  show  them  to  >-ou.  Do 
lint  appear  to  be  with  me.  but  follow  around  after 
iiK."  The  younjT  sur<r(.'on  was  no  other  than  Dr. 
('.ill  Wylie,  who  later  became  scj  stanch  a  friend 
cf  the  traininj^r  school  and  loyal  sui)porter  of  the 
cause  of  the  trainini,r  scIkk  A  C( )mmittee.  This  now 
famous  specialist  was  then  a  >-oun.i,'  man,  fresh 
from  his  Southern  country  home,  and  held  Ww  po- 
sition of  interne,  or  house-surgeon,  with  quarters 
in  the  hospital.  Mrs.  llobson  followed  him,  and 
watched  as  he  lifted  the  bed-clothes  from  a  newly- 
arri\-efl  case  and  proceeded  himself  to  jrjvc  the  i)a- 
tient— a  woman— some  attempt  at  a  bed-bath. 

It  must  have  been  such  a  ca.se  as  onl\-  o],l  Helle- 
vue  could  show,  for  the  visitor  was  horror-stricken 
iit  the  conditions  she  saw.  Dr.  Wylie  then  con- 
ducted her  to  the  old  bath-rooms  (lonj"  sincedemol- 
ish.(l),  and  pointed  out  the  litter  of  dirtv  raj^s  on 
the  ll()(,r  where  the  "nurse"  (a  ten-day  pri.soner 
trnju  the  Island)  had  her  bed.  The  dinners  came 
iqi  to  the  wards,  and  the  pieces  of  fish  an<l  potatoes 
^\y!-e  dumped  without  dishes  on  the  bare  l)oards 
"1  the  long  tables.  Finally  they  descended  to  the 
I'lnndry.  for  the  housewifely  eye  of  the  lady  had 


-vS 


A  Ilistorx'  of  Xursin'jf 


not  failed  to  rest  u])>in  tho  dull  i,Mvy  sheets  and 
])ill()W-cases.  In  the  laundry  was  one  lone,  old, 
decrc])it  man.  lie  constituted,  in  fact,  the  entire 
force  on  dut\-  in  the  laundry  at  that  time,  and  fnv 
six  weeks  he  had  had  no  soap,  because  the  a])i)r()- 
priation  had  run  out.  Incredible  as  this  may 
sound,  it  was  the  ])lain  and  literal  truth.  For  six 
weeks  there  had  been  no  soap  in  the  laundrv  of  a 
hos])ital  containint;;  some  hundreds  of  patients, 
and  the  laundry  staff  had  dwindK'd  to  ihc  one  lone 
man.' 

On  that  day  all  the  horrors  of  old  Bellevue  were 
doomed  to  extinction. 

A  few  days  after  this  the  committee  met  to  com- 
pare notes,  and,  a.s  one  after  another  of  the  ladies 
arose  to  read  her  report  and  spoke  of  visits  made 
to  the  patients,  individual  cases  in  distres.s  helped, 
soups  and  delicacies  carried  to  them,  and  rclit^ious 
consolation  lirought  to  those  desiring  it,  the  younj,' 
chairman,  unaccustomed  to  all  public  duties,  grew 
hot  and  quaked  vvith  dread  and  mortification. 
She  had  not  talked  kindly  with  a  single  patient; 
.she  had  taken  them  nf)  beef  tea:  she  had  not 
inquired  whether  they  would  see  a  clergyman! 
Would  not  her  re])ort  sound  most  heartless  and 
aggressive?  What  would  the  others  think  of  it.' 
In  deep  embarra.ssment  she  read  her  itemised 
account  of  all  she  had  seen  at  Bellevue:  the  filth 
of  the  patients:  the  degradation  of  the  attendants: 
the  inadequacy  of  all  housekeeping  details:  tli^ 
'  From  jirivatc  sources. 


A  Trio  of  Training-  Schools        379 


■vue  were 


Slate  of  the  laundry,  of  the  clothes-rooms,  of  the 
kitchen.  She  told  of  the  tea,  souj).  and  colfee 
made  in  the  same  kettles,  of  the  food  eaten  from 
the  bare  boards  without  pkites  an<l  even  without 
knives,  because  it  was  the  o;>inion  of  some  nur  in 
the  domestic  economy  of  the  ])lace  that  if  the  pa- 
tients had  knives  they  would  cut  themselves. 

There  was  ekrtrieity  in  the  air  when  she  fin- 
ished, and  for  a  moment  tht^n-  was  silence.  Then 
a  lady  rose  and  moved  that  the  IVesident  should 
present  the  report  to  the  Commissioners  of  Charity 
and  demand  an  investis^^ation. 

That  winter  the  investij^^ation  of  the   hospital 
conditions  was  carried  on  with  the  utmost  thor- 
<)U.<,'hness  and  conscientiousness.     By  t^ood  fortune 
one  of  th(>  Commissioners,  (ieneral  James  Bowen, 
was  not  of  the  usual  politician  type,  hut  a  gt^ntle- 
nian  and  personal  friend  of  the  \isitors.     He  not 
only  assisted  tlimi  with  ofiicial  su])])Mrt,  but  bej^t^ed 
them  to  carry  then-  in\-esti;4ations  into  the  other 
e;t\  institutions.     It  was  no  doubt  owin^  to  the 
\\vi;.;ht  of  his  personal  and  civic  prestii,^^  that  the 
visitors  V.  -re  protected  a,t,^ainst  the  anta.i^onism  of 
the  petty  politicians   which,    in   the    Westchester 
I'oorhouse  and  many  other  in.stituti(.ns,  had  Ihvu 
trecly  displayed  against  them,  e\en  when   they 
were  women  of  prominence.     Only  this  one  friend 
on  the  Board  of  Commissioners  is  recorded  in  the 
minutes  of  that  institutional  invasion,  and  on  the 
Medical  Board  only  four— Dr.  Janus  R.  Wooc:.  Dr. 
Austin  Flint,  Dr.  Stephen  Smith,  and   Dr.  James 


?So 


A   I  li'^tOTN-  of  Xui'siiV'' 


M.  Maria ic  Tn  these  five  men  we  owe  tlir  initia- 
tiiiii  of  reforms  in  hosnilal  serx'iee  in  \e\\-  Ynrk. 
The  others  were,  if  ik  :  aetiveh-  in  'ipposiiion,  at 
least  (liscourai^nna.  ( )nc  of  the  ])hysicians  and 
even  a  eler^yman  who  x'isiteil  Pjellevne  puiihely 
expressed  tlie  opinioii  that  the  hos])itaI  was  not  a 
])roper  ]jhiee  for  huHes  to  \'isit,  an^!  these  eritieisnis 
illustrate  the  eharaeter  of  the  stream  of  (lisa])prii- 
])ati()n — social,  political,  and  me<lieal — which  the 
women  had  to  confront  durinL;  that  monient'i'.is 
winter. 

In  a  comparati\-e]y  short  time,  with  the  stronjj 
sujiport  of  (leiieral  Bowin,  the  \-isitors  succee<le(l 
in  makinif substantial  improvements  in  tlie kitchen, 
laundty.  and  sui)ply  departments;  hut  when  they 
came  to  stutly  a  systematic  plan  for  the  complete 
reorj^anisation  of  the  whole  hou.sekeei)ing  side  of 
{\\v  lios])ital,  Miir  and  aU  heeame  con\dnccd  of  the 
utter  ho])e!essness  of  anv  railical  or  l.istint,'  ini- 
])ro\-cment  unless  there  was  an  entire  chan<,fe  in 
the  system  of  nursinJ.,^  As  far  hack  as  1848  the 
system  of  convict  nursiuLT  had  heen.  in  theory  at 
least,  discrt'dited.,  and  tlie  liii^ed  nurses  were  su; 
])osed  to  he  seK'cted  fn  mi  an.onsj;  ])oiir  hut  rejn;- 
table  Women  of  (Uvent  habits.  This  was  an  ideal 
that  could  l)e  but  rarely  attained,  and  when  the 
visitors  bcf^an  their  investi.yjations  they  found  few 
such  W' imen  in  the  whole  buildiuLj.  .\lmost  the 
entire  stalY  "-f  female  attendants.  inel;idin,i^'  the 
",scrub-},'an;j;"  which  remained  for  years  after 
the  trainini,^  school  was  opened,  was  recruited  from 


A  'Trio  of    Trainiiv'-  School-,        ,vSi 


til-'  class  of  prU>-  oIVi'IkKts  \\lv>  liaM    l)rrn   "sent 
up,"  Jiiiislly  for  <iruiik(.'iini,'ss,  to  thr  Island    and 


\vrrccalk'( 


Ih 


(■  "  l(.'ii-da\'  ^^■<  iinni. 


th 


•-■SC,   HI  IIK' 


hospital  service,  showcil  am-  u  illini^nc 


and  keep  sober,  th 


sjirce. 


often   overlooked    if   th( 
kindlv  in  their  feelimjs  for  t 


ss  to  remain 
ey  Were  retaine(l  until  their  next 


u  nnsha]is  were 


and  even  siieh  aeeident, 


'nurses      were  at    least 


K'   SIC 


■k. 


and  this  nian\- 


them — unless  sontethiiiL,^   hapj 


)ened 


to  arouse 


their  easily  e-'-citc^l  r; 
But  e\-en   of  these   there 


i.ire  and  xiolenee^ 


-really 


Were 


Were   no   nisjjht  nurses. 
Three  ni^ht  watchmen  .L,niarded  the  wards  at  ni^^ht 


and  jnade  rounds  aniouir  th 


e  SIX  hundred  ijatient: 


It  is  said  that  they  sometimes  dru.L;,L;'ed  thosc'  who 
•re  likely  to  need  attention,  an<l  dnuik  the  stim- 
nts  that  had  been  prescribed.' 
The  visitors  accordinjj^ly  i)assed  a  rc^sohition  in 


Wc 


u!a 


April. 


1S7J,    addresscMJ   to   the   Commissioners   of 


Charity  and  be,L;^in«^r  them  to  eonseiit  to  consider 
a  ])lan  which  the  ladies  desired  to  ]a>-  liefore  them 
tor  establishinj^f  a  trainint^  school  f,  .r  nurses.  The 
Cnnimissioncrs  (throui^di  (ienrral  Bowen's  intlu- 
■)  ,uave  a  cordial  rrception  to  the  ladiics'  Uiicr. 
■xpressions  of  ai)])roliation. 


en 


ur/:  answered  it  \\'ith 


H'iwever.  the\-  deemed    it    n 


ecessar\-  to  icter  thi 


lilan   to   the    M 


eiheal 


H 


oard    tor   decision. 


Time 


Went   b_\-,    but   no   rrpl\-  cajne   from    the   .Medical 


Hoard.      I 


that  it  had  I 


iKjuirics  Were  made,  and  it   was  found 


d^eii  no  action. 


\    W-\v    ProlVssiuii    for  Wnnu 


Tiir  (  \nHtry  Mai^i. 


\( 


MMiikliii    11,    .North. 


iSS.',  p,  ,?9. 


382 


A  I  Ii^t(jr\-  uf  Xursinp 


It  lia-l  alrra(l>-  Iktii  decidt'il  l.y  the  coininitte 
tliat  a  tlKu-ouj^'h  slu-ly  of  trainini^r  systems  alrcai!' 
ill  existence  must  be  nuuk-,  an<]  Di-.  Dili  Wylj^ 
still  toivmost  ill  (k'votion  t«.  the  cause.  ..rt'ere-l  t< 
K')  to  Euro])e  at  his  own  cxi)eii>e  and  in-in-  hack  : 
t'ull  report  of  the  status  of  nursiiiL,^  al.road.  il( 
madv  his  tnp  in  the  summer,  retuniiuL,^  i,,  the  aa 
tumn,  and  brouj^du  with  him  full  and  interesting 
accounts  of  the  Xi.^htin^L^ale  school  at  St.  Thomas's, 
of  the  extension  of  the  new  system  into  other  Eni,'- 
lish  hospitals,  of  the  rise  of  (listri^t  nursins;  and  it;^ 
great  possibilities,  with  a  .i^^'u.^al  survey  of  the 
nursin-,^  conditions  in  I^-anee  and  Gennan)-.  and, 
most  important  of  all,  a  lonj,'  kiicr  of  counsel  and 
encouraj^'cment  from  Miss  Xii,ditin<,rak\  to  whom 
he  had  immediately  communicated  his  mission. 

In   view   of   the   silence   of   the   .Medical    Hoard, 
the     Hellevue    Hospital    eommittec    resolved,    in 
September.    1S72.   to  refer   the   whole  matter  to 
the    Hospitals    Committee    of    the    State    Chari- 
ties   Aul    Association,    and    this    bod\-    p>repared 
a    scheme    for    the    estaldishment    of   a    training 
school    lor    nurses    at    Hellevue,    .and    undertook 
further  ne-rotiations  with  the  ^dedical  Hoard.      Hv 
the   efforts  of   the   four  members   of   the    Hoanl 
who  were  friendl_\-  to  the  visitors  and  their  plans  - 
Drs.   Wood,    I-diiit,   Smith,   and    Markoe---a   com- 
mittee  from    the    McMJicad    Ho.ard    was   finally  ap- 
pointed   to    receive    the    communication.      Three 
(kiys  later  this  committee  presented  the  scheme  to 
the  full  Board,  and  a  unanimous  resolution  was 


A  Trio  ()f  Train in«>-  ScIkjoIs 


passed    exprcssin,^;    a])i)TY)\-al   of   its    su,Lrtrestif)ns, 
aivl   rccomiiK'iidiii.L;   it   to   the   Conimissii)mTs   of 
Chanties.     The  Conimissioners  in  turn  considered 
it.  and  finally  a<,Teed— thou<,rh  whh  reluetance— to 
.-i\-e  the  committee  of  ladies  six  wards  in  Rellevue 
!^  'V  the  traininir  ,,f  nurses.'      The  vietor\-  was  now 
oanplete.      It  was  an  exeitinn;  winter  in  Xew  V,,rk 
s(.eiety.       Little    Was    talked    of.    in    the    circles 
"•■    the    members    of    the    State    Charities    Aid, 
■:'     the    })ro])osed    reforms    and     the    i)roiected 
MiMol  for  nursrs.     Tlie   rej.ort   of  the    Hospitals 
C-inmittee  of    the    State   Charities    Aid    Associa- 
tion, dated   December  2,^   1S73.  or  just  two  days 
hvinro  Christmas,  is  a  notable  document  and  one 
which  ought  not  to  be  allowed  to  fall  into  oblivion. 
It  -ave  a  most  graphic  sur\e\-  of  the  facts  disco\-- 
•vd  during  the  visits  to  the  hospitals,  emphasised 
die  .shameful  chamcter  of  the  hos])it;i!  houseke./p- 
ngand  nursing,  noted  the  advance  of  nursing  uii- 
icr  Mi.ss  Nightingale  and  recounted  her  services 
I"  humanity,  told  of  Dr.  Wylie's  travels  ,and    in- 
u-stigations,  of  the  negotiations  with  the  Medical 
Board  and  tiieir  final  consent,  and  then  proceeded 
'■■'give  this  insi)iring  and  far-sighted  statement  of 
liirir  aims; 


In  the  i.lan  offered  for    the    cstahlishmrnt   of   the 
^'•';-iol  at    Bellcvue  we  ask  only  fur  the  e-nUrol  and 

St.-ite    Charities    Aid    Association:     Traiiiiuf^   School   for 
■■"^.-.v  to  be  attacUcd  to   Bdliiuu-,  report  of  the  Cotnmitlee 
■"I  Hospitals.-    Xew   York,    .8;;.      Called    report    .\o.     i     m 
i»'Uiid  volume. 


.V'^4  A  Hi>lnry  of  Xuihini^- 

nursing  of  six  wards:  more  than  this  it  would  be  im 
possible  to  attempt  satisfact(jrily  at  first.  In  course 
of  time  we  propose  to  benefit  not  only  Bellevue,  bu 
all  the  jmblic  hospitals,  and  also  to  train  nurses  for  tin 
sick  in  private  houses,  and  for  the  work  among  th( 
poor. 

As  the  work  advances  we  hope  to  establish  a  col 
lege  for  the  training  of  nurses,  which  will  receive  £ 
charter  from  the  State,  and  become  a  recognised  in- 
stitution of  the  country.'  Brrmches  of  this  college 
would  be  established  in  connection  with  hospitals  de- 
voted to  particular  diseases,  such  as  the  Woman's 
hosjntal,  etc.,  so  that  in  course  of  time  nurses  trained 
for  the  treatment  of  sjiecial  diseases  will  be  as  easily 
attainable  as  ])hysicians.  Connected  with  the  college 
would  be  a  "Home"  for  nurses,  whence  thcv  would 
be  su])i)lie(l  with  employment  and  ])rovisinn  made  for 
them  when  ill  or  disabled  by  labour  or  advanced  years. 
The  nurses  when  traine  would  recei\e  a  dij)loma  or 
certificate,  renewable  at  fixed  periods.  Thus  the  col- 
lege would  control  the  nurses  during  their  state  of 
pupilage,  and  protect  the  public  from  imposition,  by 
making  it  known  that  a  nurse  whose  di[)loma  or  certif- 
icate was  not  in  due  form  had  forfeited  the  confidence 
of  the  institution. 

The  work  before  us  is  not  an  inexpensive  one.  It 
should  not  be  regarded  merely  in  the  light  of  a  work 
of  benevolence,  but  as  a  system  of  education,  calcu- 
lated to  benefit  thousands  in  all  ranks  of  life,  and.  like 
the  quality  of  mercy,  blessing  him  that  gives  and  him 
that  takes. 

We  require  at  present  the  sum  of  S20.000.     A  house 

'  The  schfxil  liocamo  iticorpdr.ited  in   1.S74. 


A  r 


nf  Training  Schools 


3-- 


.i-t  he  had  for  the  Lady  Su:u  rintcndent  and  nurses: 
!i"t  a  mere  lod,t,Mnf,',  but  a  cumfortable  home,  where, 
'  r  their  daily  labours,  they  may  find  relaxation  and 
a<t.  free  from  the  depressing'  influences  of  the  hospital. 
Our  head  nurses,  on  whom  will  devolve  the  task  of 
t-:tining  the  probationers,  will  be  entitled  to  the  high 
OS  they  would  recei\c  in  i>rivate  houses.  To  the 
[TMhationers  we  shall  Ki^■^•  moderate  wa.^es,  on  a  risinjj 
s.a!c.  in  proportion  to  tlieir  usefulness  and  term  of 
service. 

The  money  which  may  now  be  intrusted  to  us  will 
\>r  placed  in  the  hands  of  a  committee,  chosen  from  the 
numbers  of  the  Bellevue  Association— y)ersons  of  e.x- 
larience,  who  will  devote  themselves  con.scientiously 
•■'  the  work  they  undertake.     The  Lady  Superintend- 
'  ;it  will  ^'o  to  England,  and  make  herself  acquainted 
■ith  all  the  details  of  her  duties,  at  St.  Thomas's  hos- 
:i!al    and    at    the     Liverpool    infirmary.     Our    head 
nurses  will  be  chosen  with  the  utmost 'care,  and  the 
:hvsicians   and    sur-eons   of    Bellevue    have    offered 
n-t  only  to  deliver  lectures,  but  to  give  personal  in- 
-^truction  by  the  bedside  of  the  patients;  and  the  Com- 
missioners of  Charities  have  testified  a  most  ready 
•■•i!Iin,!,mess  to  co-operate  in  our  work.     Under  sucji 
■  .u^pices  we  feel  confident  that  we  .shall  achieve  the 
.mio  success  that  has  already  been  attained  in  Eng- 
'•':.  if  V  -  receive,  at  the  outset,  sufificient  funds  to 
•  nchle  us  towork  without  being  constantlvtrammelled 
■y  pecuniary  considerations.'     It  will  be  seen  by  Dr. 
U';,Iie's  report  that  the  nurses  trained  in  England  are 
'  :<  fly  recruited  from  the  class  of  upper  servants.     In 


•ix  weeks  after  the  puhlicati.in  of  this  report  the  sum  of 
.300  was  contributed. 

..IL    11-25 


;86 


.•\  History  of  Nursing- 


this  country,  vnmen  n\  that   class  i'iitI  plenty  of  cm- 
ploynunt  at  hi,i,'h  \va,i,'cs;  \vc  iimpose,  therefore,  to  of- 
fcr  the  a(i\-antaj,'es  of  our  school  to  women  of  a  liii^Iier 
^'rade.'      In  this  country  we  have  a  lar.Lje  class  of  con- 
scientious and  laborious  women  whose  education  and 
early  assoeiations  wmuM  lead  them  to  asjjire  to  some 
hi.tjher  and   more   thouj,dUful   labour  than   household 
service  or  work  in  shopr:  such  as  dau,:^diters  and  wid- 
ows   of    clcrtrymcn,    jirofcssional    men    and    farmers 
throuj^hout   Xew   Knudaml  and   i!ie   Xortiiern  States, 
who  have  received  the  j^'ood  education  of  our  conmion 
schools  and  acadcm'os,  and  arc  dependent   on  their 
own   cxcrti(^ns   for   support.     An   American   woman. 
with  such  an  t'liueation,  and   her  heart   in  the  work, 
could  be  traineil  to  make  the  be^t  nm-se  in  the  world, 
for  the   race   has   ready   wit.   (piick   perception,   and 
vStronj,'  powers  of  observation.      Let    her,  in   addition 
to  these  qualities,  acquire  the  habit  of  obedience  and 
you  h.ave  all  the  elements  for  makin,?  a  pood  nurse. 
To  such  women  we  arc  prepared  ti>  offer  a  career  of 
the   widest    usefulness:  a   profession   acquired   under 
masters  of  the  hijjhest  skill  (physicians  and  surgeons 
of  not  only  American  but  of  ICuropean  fame)  and  an 
assured  means  of  lixelihood.     There  is  an    idea   pre- 
vailin;;  anionj,'  certain  classes  that  the  work  of  nursinjj 
can   best    be  done    by  persons  who  receive  no  pay. 
but  simpl)   a  support  from  the  order  to  which  they 
belonj.;   -that  the  receipt  of  money  jjives  the  stijjma 
of  servility  to  the  work.     While  we  would  not  in  any 
way  depreciate  the  usefulness  of  those  holding  these 
views,  we  feel  that  the  idea  is  an  erroneous  one:  that 


'  Women  of   till-   tl.iss   lirrc 
without  ililliciiltv 


11,1,..!    1, 


'htaincil 


A  Trio  of  Tr;iinin<^^  School^ 


:v^7 


such  a  rule  simts  out  a  \  ast  nuinl)cr  wliosc  services 
W(iu!(i  ])c  invakialile. 

W\y  shnuM  nni  Christian  women  receive  proper 
remuneration  for  their  services  as  wcli  as  Christian 
men?  I)(jes  not  our  Divine  Master  tel!  us  that  "the 
Iahr)urer  is  worthy  of  his  hire  "? 

C;Mi(li(l;iUs  for  this  work  must  not  l.lin'i  themselves 
to  its  (iithculties.  In  the  wanls  of  a  pauper  hospital 
they  must  come  into  daily  contact  with  \ic<'  an<i  ths- 
ease  in  their  mor.t  repulsive  forms;  deeply  jjrasvn  nn 
Iheir  hearts,  and  reflected  in  their  lives,  must  l.c  the 
words  of  St,  i'aul:  "Charitv  sulTereth  ion,-  an.I  is 
kind;  chanty  envieth  not:  charitv  \aunteth  not  it- 
self, is  not  pufTed  up,  doth  not  I.ehave  itself  unseemly, 
seeke-h  not  her  own,  is  not  easily  provoked,  thinkcth 
lio  «nil;  rejoiceth  not  in  iniquity,  hut  n  loiceth  m  the 
truth:!. caret  h  all  thin-s.  believeth  all  tinnj^s,  endurcth 
all  tliinj^'s." 

We  wish  our  candidates  to  he  relij^'ious  women,  hut 
uo  do  not  recjuire  that  they  shoul.i  belonj,'  to  any 
,i;iveu  sect.  To  Catholic  and  Protestant  our  (h)ors  are 
equally  open;  we  impose  no  vows,  we  sa\-  to  all.  in 
the  words  of  the  holy  founder  of  the  order  of  the  Sis- 
ters of  Charity:  "Vour  convent  nmst  he  the  houses 
of  the  sick;  your  ceil  the  chamher  of  sutTerinK.  your 
rhapel  the  nearest  church;  your  cloister  the  streets 
of  a  city,  or  the  wards  f,f  a  hospita!.  the  promise  of 
ohedience  your  sole  enclosure;  your  ^'ratc  the  fear  of 
^""'d,  and  womanlv  modesty  your  only  veil." 
For  the  Commiffeeon  Hospitals. 

Elizahetii  IIonsoN, 

Chairntan. 


Ail  ohstacles  beinu:  removed,  , 


1      •^ll'u'.IlUlllttCC 


3SS 


A  History  of  Xursin 


was  appninte.i  i>>  paparr  a  workiiiL;  phm   f.  .r  thr 
projected  scho(jl  an.l  b.  ,!eal  wiih  all  of  the  j)relini- 
inary  details  nf  its  orL^atiisatiMii.     Tlii>  rr)mnntt,.c. 
which  dealt  so  l)vi|]i;,nt]\-  and  aM\  w  illi  ll-r  vcspoii' 
siliility  cntnistcd  t,,  u,  an-i  aehirwd  a  sueecss  that 
has  e(.m])lrtcl\-  n\  ..lut  j,  niiscd  the  can'  of  the  sick 
ill  thr  Xr\\    World,  was  enii:p(,se<l   of  tile   folloAN"- 
in.i,'    members:     .Mrs.    W.    II.    O.sl.orn,    ehairmaii; 
Mrs.    Rouert    \Voo.l\\<  nth,    sreretar\-;     Mrs.    Wni. 
Preston    (^iiflin,    Mrs.   <!'(  )reiiiieul.\,    .Mi-.s.   Josej)!) 
Hohson,    Miss   Wool.sey,   Miss    I-dlen  Collins,   Mi.ss 
Julia   Could,    Mr.    II,nr\-   G.    Stel.l.ius,    trcasurrr; 
Dr.   W.  ('..   Wyhr.  .Mr.  Chandler  R.dhins.     Their 
>-ears  ol  de\-i-ied  and    untirin^r  ser\iee   can    luwcr 
be   too   hi.i^hly  estimated,    and    their   names    will 
claim   the    jrratitiule   and    recognition  of    fuiuie 
generations. 

Mi.s.s  Nightingale's  letter  h>  Dr.  Wylic  i)rove<l  to 
be  a  strong  sujiport  t"  the  women  in  th.  r;  experi- 
ment. Omitting  .some  purely  personal  details  of 
'xplanation  for  not  ha\  ing  been  al)ie  to  ree-.iw 
him,  the  Ktlrr  ran  as  tolh^ws: 


I  wish  }i)ur  association  (iod-.spi'cd  with  all  inv 
heart  and  s-ml  in  th.cir  task  o{  reform,  and  will  gladly, 
it  I  can,  answer  any  questions  you  may  think  it  w(;rth 
while  t(.»ask. 

You  say  "the  -real  diiheulty  will  be  to  define  the 
instructions,  the  duties,  and  position  of  the  nurses 
in  distinction  from  those  of  me<lieal  men,  and  you  are 
anxious  to  get  my  views  in  relation  to  this  subject." 

/.v  this  a  ditfi(  ul(>  '  A  nurse  is  not  a  "  medical  man." 


A  I'rio  of  Trainino-  Schools 


589 


Xor  IS  she  a  medical  woman.     TMost  carefullv  .lo  wc 
m  our  trainincT,  avoid  confusn.n.  both  practically  and' 
theoretically,,,}-  lettinj-  wcmien  suppose  that  nursint,r 
duties  and   medical  duties  run   into  or  overlap  each 
other;  so  much  so  that,  thoutjh  we  often  have  been 
asked  to  allow  ladies  intending  to  be  "I)(,ctors"  to 
come  in  as  nurses  to  St.  Thomass  hospital,  in  order  to 
"pick  up"— so  they  i^hrased  it— professional  medical 
knowledge,  we  have  never  consented  even  to  admit 
such  applications,  in  order  to  avoid   even    the   sem- 
blance of  ciu  ouraj^ang  such  gross  ignorance,  and  dab- 
l>I..ig  m  matters  of  life  and  death,  as  this  implies    Vou 
who  arc- a  "medical  man."  who  know  the  difTerence  be- 
tween the  professional  studies  (jf  the  medical  student 
■  •  en  the  i.jlest,  and  of  the  nurse,  will  readily  see  this  )' 
Nurses  are  not  "medical  men."     On  the  contrary   the 
'lurses  are  there,and  solely  there,  to  amy  out  the  'orders 
:  the  mediral  auJ  surgical  staff,  inclu.ling.  of  course 
■■■■■  wlinh.  practice  of  cleanliness,  fresh  air.  diet,  etc' 
llie   whole  organisation   of  discipline  to   which   the 
nurses  must  be  subjected  is  for  the  sole  purpose  of 
enabling  the    nurses   to   carry  out.  intelligentlv  and 
faithfully,  such  orders  and  such  .luties  as  constitute 
the  whole  practice  of  nursing.     Thev  are  in  no  sense 
medical  men.     Tlu-ir  duties  can  never  clash  with  the 
medical   .luties.     Their  whole  training  is  to  enable 
ttiem  to  understand  how  best  to  carrv  out  medical 
and  surgical  orders,  including  (as  above)  the  whole 
art  of  cleanliness,  ventilation,  for.d.  etc..  an.l  the  reason 
■vhv  this  is  to  be  <lone  this  way  and  not  ///,;/  way. 

And  for  this  very  purpose -that  is.  in  order' that 

tiiey  may  be  competent  to  exei  uto  medical  dircc- 

■ '-ns— to  be  nurses  an.l  n.)t  .l..ctors     thev  must  be. 

:■  discipline  an.l  inirmd  m-.nag.-mcnt.  entin'lv  under 


300 


A  1  listorx'  of  XursiiiG^ 


a  woman,  a  tiai;:cd  siipcrinlcndcnt .  whnsc  whulc  I)usi- 
ness  is  to  sec  that  the  nursini:  'hitiis  are  ]irrionneil 
aceoriliii;^'  to  this  staiKhir'l.  I'"i  ir  this  |iiir]iose  may  I 
say : 

1.  That  th.o  nursiiiL;  of  hospitals,  inchKhn,:,'  the 
(•an\vii\i;  out  of  Tueilical  olVu-ers'  orders,  must  lie  done 
to  the  satisfaction  of  the  inedieal  ollietTs  whose  orders 
ret,nirdin.<,'  the  sick  are  to  be  carried  out.  And  we  may 
(leiiend  ujion  it  that  the  hi.irlily  trained  intelH,i,'ent 
nurse,  and  cu!li\-ati'il  moral  woman,  will  do  this  better 
than  the  ij,'norant,  stu]-id  woman,  for  i.irnorance  is 
always  headstr()n<,^ 

2.  That  all  desired  changes,  reprimands,  etc..  in 
the  nursin.t;  ;ind  f' ir  the  nurses,  should  be  referred  by 
medical  oHicers  to  the  stipeniitcitdciit. 

That  rules  which  make  the  niatrou  (superintend- 
ent) and  nurses  responsible  to  the  house  surtjeons,  or 
niedii  ,d  and  sin\i;ic;tl  st.atYs,  cwvpt  in  the  sense  of 
carryin-.;  out  current  medical  orders,  above  insisted 
on,  are  always  fouml  fatal  to  nursin}^  discipline. 

That  if  the  medical  otVicers  have  fault  to  find,  it  is 
bad  [lolii-y  for  them  to  reprimand  the  nurses  them- 
selves. The  medical  stall  must  carry  all  considerable 
complaints  lo  the  matron:  the  current  complaints, 
as,  for  instance,  if  a  patient  has  been  nej.jlccted,  or  an 
order  mistaken,  to  the  ward  "Sister,"  or  the  head 
nurse,  who  must  ciki'itys  accompany  the  medical  otTicer 
in  his  visits,  receive  his  onlers,  and  \)v  responsible  for 
their  beinj;  carried  out. 

!.\11  considerable  com|j|aint  against  a  liead  nurse, 
or  ".Sister,  ■  toj^'o,  of  course,  to  the  matron.) 

3.  All  discipline  must  be,  of  course,  under  the  ma- 
tron (superintendetU)  and  ward  "Sisters,"  utherwi.se 
nursin^j  is  imp(  issible. 


A  Trio  of  Trainin--  .Schools 


391 


An.l  luTc  I  shui.I.i  ad,I  that,  unless  there  is,  so  to 
speak,  a  hirranliy  nf  ^vomen--as  thus:  matron  or 
supennten.lent.  Sisters  or  hea-l  nurses,  assistant  or 
ii',-ht  nurses,  wanimaids  or  scrul,hers  (.,r  whatever 
other  gra.les  are,  loeally,  eons.dered  more  appro- 
priate)—discipline  becomes  impossil)le. 

In  th.is  hieranhy  th.e  hi-her  -"ade  ou-du  ahvavs  to 
kn-'.v  the  duties  of  the  lower  Letter  than  the  J,nver 
.i^ra.le  docs  itself.  And  so  on  to  the  lic  ad  Other- 
wise, hou-  u-ill  t'uv  l.e  al.le  U,  .'.,,/,,/  '•  Moral  influ- 
ence    aloiu.  will  iiMt  make  a  .u.m,,]  traini'r. 

Any  special  .juesti..ns  which  v-.u  mav  like  t..  ad-lress 
"■  nie  I  will  «io  my  l.cst  to  answer  as  well  as  I  a,n  al.le 

l^ut  1  am  afraid  that,  without  knowin-  vcmr  special 
.asc,  I  shall   he  .,nly  cMttusm,^^  if  I   add   much  more 

IH/W. 

r  will,  therefore.  on!v  now  mentinn,  as  an  instance 
that  the  verv  dav  I  receive.]  vour  lirst  niessaj^e 
(throu.t:h  Mr.  \\-ardr,,,,.:o  I  nreivc.,1  a  leMer  from  a 
well-known  (;erman  ph>s,rian  strikin-lv  exciiiplit\-- 
in;,'  what  we  have  been  saying'  as  to  the  necessitv  of 
hospital  nurses  bein.ir  in  no  wav  under  the  medic.al 
stair  as  to  Jisn-plinr.  but  undc^r  a  matr-m  ..r  'Midv 
supennten.lcnf  of  their  own.  who  is  responsible  for 
ih.'  carrymj,'  out  of  medical  orders. 

V,m  are.  doulnless,  aware  that  this  is  bv  no  means 
t  h..  custom  in  Cermany.  ,  [n  France  the  system  much 
more  nearly  approaches  to  our  own.)  In  Germany 
.1,'enerally  the  wanl  nurse  is  immcJiatclv,  and  for  cverv- 
tlntiR  under  the  wanl  d-ctor.  And  this  led  to  cons'e- 
quenoes  so  disastrous  that,  ^oinj,'  into  the  opposite 
extreme,  KaKserswert li  and  other  German  Protestant 
deaconesses'  institutions  were  form,.!,  where  the  chap- 
lain and  the  "  Vorsteherin"  (female  superinten.lent) 


39- 


A  I  Ii>U)ry  of  Xursin;^' 


were,   x'ftually,  masters  of  the  hospital,  which  is  of 
course  absurd. 

My  friend,  then,  who  has  been  for  forty  years  med- 
ical officer  of  one  of  the  largest  hospitals  in  Germany, 
wrote  to  me  that  he  had  succeeded  in  placin.L,^  a  oa///.';; 
over  his  nurses;  then,  after  one  and  a  half  year,  she 
had  been  so  persecuted  that  she  had  been  compelled 
to  resign;  then,  that  he  had  remained  another  year 
trying  t"  ha\e  her  reiilaccd;  lastly  that,  failing,  he 
had  himself  resigned  his  post  of  forty  years,  believing 
that  he  could  do  better  work  for  his  reform  outside 
the  hospital  than  /;;  it. 

It  seems  extraf)rdinary  that  this  first  essential,  viz.. 
that  women  should  be,  m  mattersof  disciplim  .  under  a 
woman,  should  need  to  be  advocated  at  all.   But  so  it  is. 

And  I  can  add  mv  testimony,  as  regards  another 
vast  hospital  in  (irrm.any,  to  the  abominable  efi'ccts  of 
nurses  being  directly  responsible  uot  to  a  matron,  but 
to  the  economic  statT  and  medical  statT  of  thei'-  hos- 
pital. And  I  am  told,  on  the  highest  authority,  that 
since  my  time  things  have  only  got  worse. 

Hut  I  will  not  take  up  your  time  and  my  own  with 
more  general  remarks,  which  may  not  j  .ovc,  after  all, 
applicable  to  your  special  case. 

But  I  think  I  will  venture  to  send  you  a  copy  of  a 
paper — the  only  one  I  have  left.  The  original  was 
written  by  order  of  the  (then)  Poor-Law  Board,  f"r 
their  new  workhouse  infirmaries,  and  ])rinted  in  their 
reports.  So  many  hospitals  then  wrote  to  me  to  gi\e 
them  a  similar  sketch  for  their  special  use,  and  it  was 
so  utterly  imyiossible  for  me  to  write  to  all,  that  I 
abridged  and  altered  my  original  paper  for  their  use. 
And  this  (I  fear  dirty)  copy  is  the  last  I  have  left. 
Pray  excuse  it. 


A  Trio  of  Training  Schools        393 

A,c;ain  bi-.L^'piiiL;  you  to  command  nie,  it  I  can  be  of 
an_\-  use  for  your  .ercat  ]nir{.osc,  to  which  I  wish  every 
success  and  c\cr-increasinjT  j)rojTress,  pra\-  bclic\e  me, 
'^''■'  I^vcr  your  faithful  scr\ant , 

Florence  Xightixgale. 

P.  S.  ^  ou  will  find  in  the  appendix  to  tlie  printed 
paper  all  the  steps  of  our  training  at  St.  Thomas's  hos- 
:ital,  under  our  admira])lc  matron,  .Mrs,  Wardroper; 
l)ut  as  she  may  i)robably  see  this  letter.  I  must  abstain 
from  praisinsT  her,  as  it  were,  "to  her  face,"  which  all 
noble  natures  dislike.  p    x 

I'crtifiL'd  by  the  counsel  and  cncnuragcincnt  of 
Mis.s  Xi^htint,Mlc.  the  ai^pc.-.l  to  the  New  York 
(iMblic  prcvioiislv  (piotcd  froin  was  issued  b\-  the 
■.  "niinittee,  with  the  ,i:rati!yin,L;-  response  of  funds 
.:<  inentioncd,  and  the  eojinnittee  ajrreed  to  be  in 
•■•adiness  to  open  tiic  training  .school  on  the  first 

:  M.-iv.  .\  liousi-  \v,-is  ront''<l  near  tlie  Iv.spital  as 
:  lioinc  for  nurses,  eiretd.irs  wimv  issuei]  inviting,' 
:>up\h  to  a])]il\-,  and  seandi  was  made  for  a  supcr- 
:nten(!ent.  Time  p.,ss,-d  .md  no  suitable  person 
•or  this  ])ost  w,is  found,  and  the  committee,  with 
■i-.uch  anxietA,  .saw  the  first  of  May  a])proachin{T. 
\\  e  m,i\-  borrow  from  the  man,ii;ers'  later  account 

iio  prelt\-  little  aneedoto  of  how  this  uncertainty 
'  .IS  ended: 

A    member   of   the    committee,    in    a    ilcspondcnt 

niood,  at  this  time  expressed  her  anxietv  to  another, 

vho  replied.  "I  have  such  faith  in  tins  work,  and  I 

.i\e  prayed  so  for  it,  that  I  shall  ha\e  that  supcrin- 

•  ndent's  bed  made,  being  sure  that  she  will  come  to 


394  A  History  of  NursinL'- 


occupy  it."  A  fen-  days  later  the  former  lady  was  at 
lier  hreakfasi  talile  wlien  a  woman  in  the  <:ar!)  ..f  a 
vSistcr  was  announced.  Her  En.L,disli  accent"l)el rayed 
her  nationality  as  she  cxplaind  that  she  Iiad  heard 
we  were  establisliin,:;  a  trainin.i^^  schf.-.I  fur  nurses 
in  W'w  York,  and,  as  she  h.ad  had  c-msiderahle 
experience  in  such  work,  she  Iiad  come  to  offer  her 
services.  ' 

This  was  Miss  BtAvdc-n,  known  as  Sister  Helen,  of 
All  Saints  Sisterhood. of  London  and  Haltitnore  (for 
a  braneh  of  the  community  had  been  esta])lishe(! 
in  the  latter  eitv,  and  Si.ster  Helen  had  been  in 
residence  there  when  the  circulars  and  inciuiry  for 
a  superintendent  had  been   published),  who  had 
been  trained  in  University  Collei,re  h(  )spital,  London, 
where  she   was   distinj^niished    as   a    fine   medical 
ntirse,  an  exetdient  teacher,  and  elTeet  ive  , adminis- 
trator.     Havini.^  s<,me  time  ;it  her  dis])osal  before 
returnin-  to  ICii-land.  she  h.ad  e,,ine  to  X,-w  ^'ork 
to    ])roi>ise    undertaking;    the    new    work.      Sister 
Helen  was  en-at^ed  without   del/iy,  ;md  th(>  .stdiool 
opened  aecordin,i;  to  ])rnmise  on  the  first  of  M.av, 
m    free  wards.      It    is  easy  to  inia-ine  \vhat   the 
dil'lieulties    must    ha\e    been,    but    since    matters 
turned  out  wtdl    they  have   been  f.  .ryotten.     The 
manat^ers"  hist<>r\-  sa\s: 

At  tliecxi>iration  of  tlie  first  year  the  liouse  nie-l- 
ical  staff,  who  luui  been  friendly  from  the  he.i^Mnnin^'. 
ventured  to  point  out  to  their  superiors  the  imi)roved 

'  History  oj  the  Establishment  of  the  HcUcvuc  Training  School 
jor  Xiirsi-s.  cit  .  pp.  5-0. 


»« 


V 


x^-- 


.^^^  ■*-* 


» *% . .. 


ITSv'v  :: 


for  N 


ir-t>  Ciiniicclid 


'i    "I    MIU    A,   u     \  ,,,1^      |- 


»i!ll    lilllcVUf    111 


•|.il;il 


iiiiiii(^'  Sclidol 


.-V.  \ 


A  Trio  of  Training  Schools        395 

condition  of  the  nursinn:  service  under  the  training 
scIkuiI,  anrl  ,i,M-adually  the  eyes  f)f  these  j^-entlemen 
were  opened  to  the  fact  that  their  patients  recovered 
sooner,  anrl  the  deaths  after  operations  v.rre  less  fre- 
'pient,  than  formerly.  The  su[)erintendent.  Sister 
Ililen,  accustomed  to  tin-  niana^'ement  of  a  paup-er 
hospital  in  Kn-land.  and  to  deal  with  workhrmse  au- 
thorities, was  not  dauntci]  |,y  the  politics  of  Bellevue. 
s<..  gradually,  durin-  i!u  sccon.l  year  the  work  as- 
sumed permanent  shaiie  and  was  extended  to  other 
wards.  The  applications  t'rom  wouM-be  pupils  in- 
creased; the  lirst  pupils  became  head  nurses,  and  at 
the  close  of  the  second  year  the  first 
jijraduatcd. 


class 


DuriiiL:  US74  totir  more  wards  were  t^Mwn  over  to 
the  scli(K)!,  jnakiipiy  nine  in  vUm^v  of  the  nurses. 
The  in(k>l)teilness  of  He]le\-ne,  and  thniu,L,di  it  of 
the  nursinj^r  ])rMfessi(in  ,L,^eiH'ra]l\-  in  the  United 
States,  to  Sister  ilc'lon  can  hanlly  l>e  too  warmly 
acknowledi^r^,,!,  ;,,!(]  it  can  only.  indee(i,  ])e  properlv 
estimated  ]>\-  lookini^r  hack  upon  it  from  the  pres- 
ent time.  A  stron,L,r  and  dominant  charrictcr,  of 
marked  executi\-e  ahilitv  and  thorou.L^di  mi.stress  of 
her  drmiain,  sh-  hiid  the  firm  foundations  upon 
which  the  Ikdk  rue  school  has  .stood  unsliakcn  all 
these  years.  I  ler  lirst  and  unvarvin^:  position  was 
to  exact  respect  and  consideration  for  the  nurses 
from  everyone  in  tlu'  hns]Mtal,  as  she  demanded 
deference  for  herself.  A  l)ulk\-  and  impo^-'nir  fitr. 
ure  in  her  rclii^nous  .earb,  of  hea\-\  and  prelate-like 
counten.ance,  her  chief  jiersonal  charm  was  a  voice 
ot  unusual  sweetiitss  and  refinement  of  cnnncia- 


196 


A  History  of  Nursing 


li(jn.     A  strict  ilisciplinarian,   she  lovcf]   to  rule 
but  she  ruled  wisely.     She  was  not  lavish  of  prai.se 
even  to  those  she  most  x'alued,  yet  after  searching 
criticism  or  sewre  admonition  slie  kn^w  how  tc 
administer  the  sweet  with  the  bitter  by  commenda- 
tion, and  no  faithful  efforts  escaped  her  notice, 
Of  strong  and  \-er}-  ]jositive  opinions,  she  was  not 
without  egoism  and  sometimes  failed   in  tactful 
conciliation.     A    rt'ligious    woman,    an(i    a    thor- 
oughly good  woman,  she  ^\■as    not  easilv  under- 
stood, and  few  reached  lu^r  innermost  confidence, 
but  those  who  did  so  gave  her  steadfast  affection 
and  loyalty.     She  in  turn  was  lo>-al  to  her  nurses, 
protected    thrni,  and    insjM'rei]    tlirni    with    a  full 
sen-e  of    tl'e  gravit\-  of   their   rc^ponsiljilities.     A 
certain    jealousy    is   th^'  natural    complement    of 
forceful   natures,  and    this  was   not   absent    with 
Sister  Helen,   though   it   was  for  her  work    more 
than  for  herself,  unless  one  might    sa>-  that  her 
work  was  herself. 

Fortunately  for  the  school  the  warden  at  that 
time  became  a  firm  frien<]  of  Sister  Helen  and 
the  nurses  and  it  was  his  wont  to  send  then 
warnings  \vhen  skirmishes  \\ith  the  enemy 
(in  the  shape  of  unfrien^Ih-  jtolitieians)  were 
likely  to  be  expected.  These  Worthies,  who 
had  once  accepted  so  indifferently  the  bad  condi- 
tions of  Bellevue,  were  now  keen  to  inspect  the 
nunses'  wards  and  alert  to  find  causes  for  criti- 
cism. ()n,>  of  the  first  class  of  nurses  has  told  of 
the  rounds  they  usc>d  I0  nij.ke  in  the  bath-rooms 


A  Trio  of  Training  Schools        397 


and   corners,    even   wiping   the   walls   with    their 
hamls  to  see  if  any  dust  eould  lie  found. 

Ik'llevue  also  owimI  a  dcl^t  to  the  school  of  the 
\r\v  I'jii'land  h'lspilal,  for  this  jiionccr  institution 
srnt  it  two  head  nursrs,  .Mrs.  W'l  ill-iau]itcr  and  Miss 
Woods  and  a  night  sui)erintcndeiit.  .Miss  Richards, 
n-om  its  Hrst  cla.ss  of  graduates.     .Miss  Richards, 
whose  reminiscences  cover  thr  wh^lf  rarl\-  field  of 
nursing,  eanie  to  P,elle\-ui' from  her  (//;;/(/  tnatcr  un 
the  first  of  Oetolier,  when  the  si'hool  was  oui     fi\-e 
months  old.     After  a  day  or  two  in  tlie  wards  she 
was  put  in  charge  at  night,  with  the  following  in- 
structions from  wSister   Helen:     "You  are  to  see 
'  ii  head  nurse  before  she  leaws  for  the  night, 
•    1  take  her  orders;  _\-mu  are  to  send  all  calls  to 
':;  '  physicians,  gi\e  all   nie  lieines,  take   ptTsona! 
lare  ot  all  seriously  ill  ]>atieins,  instruct  the  nurse, 
111  their  duties  e\-er\  hnur.  and  rejxirt  to  each  head 
nurse  before  going  oft  dut\-  in  the  morning;."     The 
school  then  had  tiw  war  Is  and  ab'iut  fiie  hundred 
patients.      Reports  and  orders  were  all  \-erbal  an^l 
It  was  through   Miss  Richanis's  notes  of  a  easi\ 
written  to  hel])  one  of  the  da\- tiurses  in  the  note 
taking   recjuired  of    the    laquls    by    Sister    ilrlen. 
that  the  system  of  written  day  and  night  renorts 
and  orders  came  about;  f'  <v  onv  of  the  pliysieians. 
finding  the  written  record  of  the  night  fir  one  pa- 
tient, was  so  ple;iscd  with   it  that    no    time  ^\•as 
lost    in   establishing  the   rule   of  written    reports 
thre.ughout. 
The  managers    of    the    school    had     from    the 


;>y>- 


A  I  listorx   of  Xursiiv,'' 


<'Ulst'l  ;KH-('])t('il  ^!lss  Xi^IuiiiL^alr's  ]iriiiri|)lr.s  as  to 
ihc  iiitrni;il  nrL^anisalii  m  aiii!  disciplini'  luvcssarv. 
T\k-\  sa\-  I  III  tin's  ]ii  lint : 

The  jiritiriiik'  which  Miss  Xiir'-.tin.i^'alc  insisted 
tip' 111  ;is  fuii'laincntal  and  which  excited  the  j,'reatest 
oj-jiositidn  ainnni,^  lios])ital  authorities  was  that  all 
nurses  sh'nilil  In  matters  of  disci])line  he  undt  ■  a  wo- 
man, who  slmuld  be  res{)onsihle  to  the  hospital  author- 
ities for  the  hehavinur  of  her  subonlinates.  and  f>ir  the 
faithful  pcrfiirnianee  of  their  duties;  that  all  eoni- 
phiints  should  ,l;u  t"  her  to  he  investii^ated.  and  he  hy 
her  refi'rrcd  to  the  supreme  authority,  whetlier  warden 
or  medical  sujierintendent.  This  was  such  an  innova- 
tion in  h:;spital  rule  tlu't  it  treated  threat  opposit'-^n 
at  first  in  this  country  as  well  as  in  Kumjie;  I 
fiillowinj^  t'-,>  advice  of  Miss  N'itjhtinjjale,  the  eomniit- 
tec  stood  firm,  carried  their  i)oint.  and  as  time  passed 
and  the  nchool  extended,  until  it  controlled  all  the 
luirsin;;  in  the  hospital,  the  rule  was  aceeiiteil  without 
a  question,  and  as  other  schools  were  founddl  the 
superintendents  carried  these  rules  with  them,  until 
now  no  other  system  is  in  use  in  any  hospitals  in  Knjj- 
land.  nor  in  civil  hosjutals  in  this  eountrv. 

Ill  "till 'r  details  of  fiiriii,  Ikau  \cr.  tlic  innintittcc 
did  not  aim  t<«  foHcAv  cldsch-  thi  iln-Iisli  tmidcl, 
hut  devel(t,K'(l  on  their  own  lines  in  aironlance 
with  the  differences  in  our  social  structure.  Most 
iiiiI)ortant  of  these  modifications  \vas  the  definite 
and  intentif.nal  exclusion  of  the  domestic  servant 
clas.s  and  the  di'termin.ation  to  olTer  the  traininji 
only  to  tho,si'  Women  who  had  had  hctter  educa- 
tional  adwinta.ires.     This   decision,    which   is  set 


A   Frio  of  Traininij  Schiu)!.' 


599 


)rth  in  thr  ;(I.(.\c-(|:,i(,t(..,]  ri'jii  ui  of  tl 


(i\  w'lUih 


M 


vs. 


>>' >n  ^\■as  chairiiian,  is  i  iiu' df  the 


thinLfs  li  ir  w 


h  \\c  haw  Id  iVvl  most 


.Lrratt'tul,  h)V 


it  has  i)rf\x'iii(,''l  the  >.  .isd 


>IK' 


h  jiractifal  hindram. 


Inn's  w  hirli  ha\c  ] 
I)SU 


)n(\-f(i 


iuraii(-TS  and  obstacles  to  proj^rcss 
insMiiK'  oi"  thr  ( )M-\VorM  iiistitulions,  set  the  j^^'nc- 
(Tal  staivlar.l  (wiih  S(  une  few  exeetitions)  for  the 
wiioli'  eouiUr\-,  ami  supiilicil  ,,111-  hospitals  with  a 
si't  ol  Wdiiuii  (.f  finlv  similar  aims  ami  i'lrals,  who 
are  eiiahlcl  tr,  ad  toij;elher  with  uiiammitv  ami 
-,,.,(!  tVi^lin-  not  < 'ihcrwisi' jjossihlr.  It  is  not  too 
::!'irh  to  sa\-  that  the  eomparatiw  hom();;eneity 
I  he  nursim;  j.n  .U-mou  thus  attaint'd  has  faeihta- 
lale.l  an  eduealional  ad  mee  winrh  has  Ihth  (,t" 
distinet  scr\  ire  t'  >  thr  \\]]'  .Ir  rau  .1'  '  li"  ])riiiiar\'  vAu- 
;ion  and  lrehnu\,!  Irainini;.  This  wise  and  lar- 
M-hted  idi'a,  eMntcmplat inn;  not  only  llu'  ri' form  of 
•a<  hospital,  hilt  alvi  thr  MjH'nint,'  of  ilew  awnueS 
''!  seh-su]>]iort  to  c'dneatitl  UMHu'n,  orij^n'natod 
h  Mrs.  !  l.ihsoii,  \\h"sf  w  hulr  wnrl-,  on  the  I'uin- 

iiUee  was  o|  an  eminently  eonstruetive  eharaeter. 
Another  variaticn  from  the  Ivni,dish  model  was  the 

horter  eonrsc.     As  at  St.  Thomas's,  h.  re  ton  tlie 

:ainin},'  was  rcsrarded  as  complete  in  one  year; 
diat  is,  iiistruet  ion  was  not  e.  mtimud  altrr  that 
i'eriod.  but  the  nurse  was  -^-ily  bound  by  contract 

'r  one  year's  service  aft     the  traininj,'  year,  mak- 

1:11:    practically    a   two-ycars'    course  before    she 

VI  lived  her  certificate  and  left  the  school.    A  fur- 

'    !■  dilTcrence  was   in    t!i>    complete  e.xodus  of 

I'Upils  it  the  end  of  thi  ir  lourse  of  traininj,',  for  our 


400 


A  llist()r\-  of  XursinL'" 


linspitals    'lid    not    otk-r    paiM    jxisitions    t</    lioad 
nurses  and  scninrs,  liut  rrlird  alinM.>t  riuin^ly  on 
Idle     stT\i(.H'     '^iwu     in     cxchanL^i.'     for     training; 
tiiialh  ,  a  marked  difUTcncc  from  all  ('<  mtincntal 
schools,  and  iVmhi  those  h.n.ijlish  ones  that  had  ful- 
lowed  St.  'idinnias's,  was  in  the  entire  anij  n'CO"-- 
niscd  indrpeiid.-nei',  after  irainint^',  'if  the  inirse, 
who  I'un  erased  {<>  !»'  nndcr  the  i^niardianshij)  f)f 
her  seliMi,!  e.\er])t   in  si  i  far  as  she  jr.ii^ht  depend 
ujjon   it    aif  ealls   [>  <  ]ii-i\-ate  cases.      I-'nr  this  ser- 
vice she  paid  {]v  scIimmI  a  n'^^nstrv  fee,  hnt  lived 
where  shf  ])liased  and  recei\cd  1,  r  earninL^s  her- 
selt,  in  eMntra<listiiK'ti(in  in  the  fhi'dish  inirse.  wh.; 
joined  a  ])rivate  staff  and   ix'eei\-ecl  a   Ir  one  and 
sahirA',  whih-  her  earnin,L;s  wml   to  the  school  or 
association  or  hos])ita!.      Wdule  eaeh  ■■ '\   tiie  Amer- 
ican   \arialions   had   some   .id\anla,L;i  s   and    sonic 
draw  hacks,  we  shall  not  now  enter  in    <  them,  hut 
lea\-c  their  consideratiMji  fir  anotln-r  time.' 

The  discipline  and  seir.i-militar>-  atmosphere 
which  came  so  naturally  in  countries  accustomed 
to  n.m'sini:  f)rders  devcloiicd  slowh-  in  the  carlv 
American  schools.  The  idea  of  a  uniform  was  not 
liked  !i\'  the  uonim  who  first  rc~.p.  .nded  to  the  call 
to  take  u})  hospital  nursinji;,  and  it  was  not  at  once 
adopted.  The  meirihers  of  the  committee  under- 
stood very  wdl  the  moral  elYect  of  uniform,  for 

'  From  the  first  the  managers  had  hoped  to  train  nurses 
for  the  service  of  the  poor  in  thtir  homes,  and  in  March, 
iSyfi.the  first  district  nurse  trom  Bclk'vuo,  siii>p()rtcd  by  one 
of  the  nianajjcrs.  joined  tlie  Woman's  Branch  of  the  City 
Mission  for  this  service. 


A  Trio  of  Training  Schools        401 


tlu\-  ha. I  sai<!  in  the  rcpnvi  already  riunted:      "A 
Mmtnnii.   however    sirnplc,    is    iii(hsi)rii.sahlc,    and 
diMiild    lie   ri-idly  entoreed.      It    is   advanta.^e.uis 
-n  the  ,L,n-(.und  of  eeonnmy  as  wall  as  neatness,  and 
'^  elleet  cii  a  C(ir]is  of  nurses  i,-,  the  same  as  on  a 
' -nl])an^•    of   soldiers."      Hut    the    praetieal    dihi- 
ilt\-   Mas,   how  to   introduee   this   idea   into  tl;e 
mds  01    the  ])n,l,ationers;   for,  when  all  was  so 
'  \l)ermiental  and  wlieii  everxthin;,^  depended  < .n 
:nducni,L,^  the  ri-ht  elass  of  women  to  eome  forward, 
't  was  inad\isadile  to  insist  u])on  a  uniform  in  tlu' 
:  ice  ol   their  prejudiees  ai^ainst   it.      In   the   first 
class  of  nurses  was  a  dau-hter  of  an  ( .Id  and  pr.  uni- 
nt  N\'W  \  I  ,rk  hiniily.  ( m  intimate  terms  with  the 
:i<-rent  nieiiilK-rs  of  the  eommittee  and  compre- 
'    ndinsj;  tln'  situation    from   tlu^ir  ])oint  of  view. 
>:ie  was  also,  l,y  -oo.l  f.,rtune,  very  beautiful,  tall, 
'  ••'!  di,i,miiied.      She  talked  tlie  matter  over  with 
-'me  ot    the  eommittee,  ami    prohal.lv  also  with 
."^ister  Helen,  and  it  was  arran-vd  that  she  should 
•■yv  a  couple  of  (]a\s'  lea\-e  of  ahsenee.      (  >n  her 
-turn   she   made    her    a])])earance   in    the   wards 
dressed  in  the  -rexishd .hu'  strii)e  and  witli  apron 
■id  raj)  of  white.     Soeharmint^^wasshe  tohehoM, 
id  so  dowd\-  ,.nd   insi-iiifieant  did   all   die   tioii- 
di'script    print    dressis   look   beside  her,   that    jnv- 
.;ndicc   vamshed   and   as   ra])i(lly  as   po.ssible    the 
'imform  was  adopted,  .and  nev(-r  a,i:ain  (jtustioned. 
It  would  perhajis  be  too  mueh  toilaim  that  it  was, 
"1  those  (lays,  always  absnlutel\   uniform,  for  we 
M-ein  to  }jatli(  r  the  hiiit  ,,f  an  oNfrskir* 

vot.  U.~jO. 


m  the  wry 


402 


A  History  of  Nursing 


chan-iiinc,'  {'vj^wrc  of  a  nur:-  skftchc<l  frnm  life  in 
t!ir  i.cxl  ilicaiU',  ,111(1  usf(l  to  illustrati'  an  article 
(K'aliiiL:  with  ihc  ii^-w  occu])ation  for  wonu'ii.  The 
dress  fi  >r  w  inu.r  ainl  snmimT  x-aricd  at  first ,  for  thr 
fourth  annual  rcjxirt,  Januar\-,  1S77,  says  on  this 
])oint:  "The  ]ni])ils  arc  i\'(|uiriM]  to  wear  the  dress 
ot  thi'  institution,  ,/;,..  a  ,uri\-  stuff  drc'ss  in  \'  inter 
and  ealieo  in  suinnirr,  sini]il\'  made,  a  'aliite  apron 
a.nd  cap,  and  ImAvn  linen  euffs  eowrin:,'  the  sleeves 
from  the  wn-^t  to  tlu'  elliow."  The  t,n-e\-  stuff  driss 
)i  ir  w  inter  wa'^  alu  'lisji.-d  in  iSSo. 

'Hie  ft  ^'viurat  ion  '  •(  tlie  old  hosjiital  was  not  ^■et 
eon;]iUte.     'i'li.  re  runanifd  one  d  jiartnieiit   -the 
most  important  of  all     wlu're  the  wdrst  possihlc 
conditions    ])n\-ailed.      This    was    ilu'    maternit\' 
dixisioii.     .\s  Ir  d  earlier  1  leen  the  t'ase  in  Kin',^''s 
Collet^e  hos]>ital   in  London,  and  still  earlier  in  the 
IIotel-I)ii  u  of  Paris,  the  ]iractical  mana,c;ement  of 
tin's  ser\iee  had  not  heeii  liroui;li'  u])  to  the  ])oint 
of  eori\s]iondinL:   witli    the   teaehinL^'s   of   medie.il 
science.      Tb"  c<immoii,st  stupidit\-  of  our  ci\il- 
isalion  is  the  faiharc  to   lirm^;  welKkiiown    scien- 
tific i)rineip]es  iiHo  d,iil\-  practice  as  h\-^Menic  and 
sanitary  nu-asurcs,  and  this  discrepancy  between 
what    is    tau},i;ht    and    what    is     'one    existed    in 
the     maiernity     <iepiriment     of     Helle\-ue-.       It 
had   loll;,'    liccn    know  11    to    medical    ,sei(-nce    that 
]m)xiinit>'   to  surL^ical  wards  was.   for  parturient 
patients,  a  most  dan^'crous  situation.     An  extens- 
ive literature  existed  on  this    su!)ject,  o,f   which 
Miss   Ni^iitinj;;ale's  udrk,   prcvioush-   referred   t  >, 


i  III-  Nuisf  ■ 
Nalui  A.  Il!im|>um,  Ittllivuc,  iSsa 
■i  fr..m  life  (.,r  the  Cnl^.y  ../,„..,.,«,,  N..,,,  .j,,.  ;„  ...v  .s„  ,.„„„,i<,„  ,  ,, 
\V  »meii  " 


A  Trio  of  Trainin^j-  Schools        403 


was  one  ot"  tlic  niosl  dt'Cmite  ciiKi  ])raclir:il.  Xn- 
nuTous  scK>ntific  jiu'difal  works  wrrc  cxtanl  that 
pnintcd  out  the  (lan-vrs  of  surL^ica]  ])^i;snti  f,,-  {]-n. 
Ivin<<-in  woman;  in  fad,  the  rcfen'ix'es  on  this 
])oint  had  prcviMusIy  l)crn  enriclied  liv  the  \-.  :-itings 
n\  a  distini;uisht>d  Bel1c\-ne  ])hvsieian,  who  had 
(■.\j)h'eitl\-  stated,  in  (i])fnin,L,r  h,s  suljject.  that  sur- 
;.neal  ]>oison  was  alni<.st  surely  fatal  to  the  {xirtu- 
rient  woman. 

^^t,  m  spite  of  the  teaehiii^s  and  warnint^s  of 
seirntifie   men.  the   maternit\-  wards   <,[    Bidlexaie 
were  situated  direetl\-  a!><)\c  the  suri^neal  wards, 
and  eomnnuiieat"d  fr^clv  v/nh  the  latlcr  ])\-  puh- 
lie  stainvays  and   eorrid^rs.      Xn  attfm])t   at   all 
was  made  tn  isoLati'  them;  on   the  e- .iitrar\-  this 
ser\iee  was  attaehed  ]■■>>. a  to  the  niedual  and  sur- 
,i,neal  ser\iees,  so  that  ihr  s.mie  set  (  i  hwuse-phy- 
sieians   or  suri^'e^ns     who  were  VMun^LT  mm    iust 
"Ut  'A  the  mcvlieal  seho,,]  and  takin.Lj;  thrir  h()si)ital 
trainint,'— went  freei\-  haek  and  forth  from  one  to 
the  other.     The   studv   of   l),aeteriolo,<;v   was   still 
'  lementary,   and   {he   rounds  from   the  operatini,^ 
tahle,  the  dissection  room,  tlu'  Innlsidrs  of  ])atienls 
M-esh  fn,m  the  hovels  <,f  the  city,  and  tlu-  ol.stetri- 
lal  wards  were  earrieil  on  without  an  attempt  to 
I'parate  one-  fn  in   the  otln'r.      So  (\,s\-   is  it   for 
ihosf  who  ari'  direi'tly  alKorhcd  in  the  seientifie 
and   ahstraet   to  forget   the  practical   application 
and  care  of  details. 

The   man;i-ers  of  the  school    h.id   ilir   ])i-,icticai 
results  hrou.i^du  !■    tin  in    n  a  j.ainful  wav  one  win- 


404 


A  History  of  Nursinfr 


ter,  for  pun-jH'iMl  ivwr  s])rca(l  from  HelU'vuc  inlfi 
the  cit}'  aiiil  (.iitrrc'l  the  hoinrs  of  some  of  ihrir 
own  friends.  Ii  l-rcanu'  cpidi'iiiic  in  the  wards, 
and  the  tliiril  anrual  i-cporl  of  ihe  Slate  ("liari 
ties  Aid  Association,  Mai'eh,  1875,  state's  that  dur- 
ing,'the  e])i(leniie  iwn  out  of  ex'ery  fi\r  wonieii  (Hed. 

The  nianai^ers,  naturalh'  enou^li,  were  unin- 
formed on  the  seientifie  side  and  did  not  at  first 
possess  a  knowledge  of  the  relation  hetwei'n  puer- 
peral se]isis  and  surt)^ieal  wards.  Sister  Helen, 
who  need.ed  all  her  di.serction,  ne\-ei-  told  all  she 
knew,  but  ilrew  the  attention  of  the  manai;ers  to 
the  forl(irn  condition  of  the  matiMmitv  wani^, 
which  were  comfortU\ss,  unsuper\-ised,  and  cjuite 
lacking  in  good  moral  atmosj)here,  and  further 
mentioned  that  she  heard  of  many  deaths  there. 

The  managers,  eager  to  hel])  the  unfortunate 
patients,  and  acting  on  Sister  Helen's  suggestion, 
that  with  a  fi'W  more  nurses  added  to  the  staff  they 
might  he  eiialilid  to  care  for  the  maternity  ward, 
went  confidently  to  some  of  the  medical  authori- 
ties to  olfer  to  undertake  this  extmsion  of  the  ser- 
vice, when,  to  their  ajTia/.cment  and  chagrin,  thev 
encountered  an  outburst  of  irritated  opposition. 
Their  olfer  a])peared  to  haw  been  looked  upon 
as  a  criticism,  for,  incredible  as  it  seems,  tlicv  weri' 
told  in  ])lain  words  that  //;(•/;-  mrJiHini^  in  the  lu^s- 
pitiA  uunuii^cniiiit  luhl  (^inic  jar  cui'm'Ji,  tinil,  us  no 
more  I'i  it  au>iil>l  he  !oln\iti\i,  it  :>■  ;!/,/  lurec  to  ivasoJ 

Astouishe'l  all']  indign.:in.t  tb.ev  retumc'l  liome, 


'  l"n  mi  iinwili'  sourtes 


A  Trio  of  Training  Schools 


405 


i'Ut  not  to  KHvc  up.  By  the  efforts  and  through 
the  mediation  of  Dr.  Wood,  the  matter  was  earned 
lunher.  and  a  time  and  plaee  ajjpointed  for  its 
Consideration  by  a  iii.^her  l)ody. 

At  this  meetin.^r  the  ladies  did  not  ap])ear  in  per- 
S'  in ,  I )ut  were  represente(  1  I )y  their  husl )an.  is. 

Jl  was  a-reed  that  the  nurses  should  he  plaeed 
ni  the  maternity,  and  in  May,   187^.  the  ehange 
was  made,  the  first  attem])t  at  ne-(,tiations  havin- 
hrvn  made  earli.-r  in  the  )ear.     The  trainin-  sehocil 
report  of  that  year  says:     "  We  applied  in  Fel)ru- 
arv  to  the  Medieal  Board  for  three  Ivin.t^r-in  wards 
at  Bellevue.      In  May  . .ur  .  A'kr  was  aecepted,  and 
the  nurses  entere<l  u])nn  the  new  held  (»f  service." 
But  still  the  ])atients  eominued  to  die,  and  in 
dee])  discouragement  and    peri)le.\itv  one  of  the 
managers  ^at  one  day  in  the  lil)rar\-'of  a  medical 
iriend,  and  e.xjn-es.sed  the  .lisappointment  and  di.s- 
iress  which  she  felt  at  hax'ing  ai)parentlv  given  no 
hetter  serx'iee  than  the  untrained  helpers.     They 
•  elt,  she  .said,  as  if  they  were  working  in  the  dark. 
The  medical  fru'n.l  was  at  that  moment   hurriedly 
called  away,  hut  as  he  departed  he  placed  an  oi)en 
h'lok  m  her  hand,  saying,  "  Perh.aps  this  will   help 
\-"U."      It  was  the  treatise  before  referred  to.  writ- 
ten by  .a  prominent  .seienti.st,  whose  services  had 
inrn  given  to  the  city  po,,r,  and  to  her  ama^'ment 
die  read  the  opening  words  enuneiating  the  doe- 
'•;ne  r)f  the  fatal  lelationshij)  between  surgieal  and 
"-.itei^nitN"  wards. 

This  was  the  light  that  she  had  fell  tile  need  of, 


4o6  A  History  n(  Xursing 


anil  aniicil  \^itli  this  ilrrlaralinii,  of  an  indisjjuta- 
lilr  .inciic'c,  the  C(,urai;i'()us  woman  returned 
sini^U'-hanili  (1  In  the  ehari^c,  eonfronted  the  au- 
thorities, and  speediily  set  in  motion  the  forees  by 
whieli  the  niatt'rnit\'  wards  were  remow  1  from  thr 
])reeinels  o!"  tln'  h' s])itaL'  The  third  annual  re- 
])ort  of  the  State  Charities  Aid  Assoeiation  says  on 
tins  point:  "  It  v.ms  throu.^di  the  rejiresentations  of 
our  X'isitini^'  Coniniitlee  that  thi,.se  wards  were 
finally  elosc'd,  and  the  remainin,;^'  twenty-five  wo- 
nun,  alread\-  sliowirii;  ,s\-niptoms  of  disease,  were 
removed  to  the  one-story  ])a\dlion  on  Black  .veil's 
Inland,  and  reeo\  (.i-ed."  Of  ihis  transt'er  of  pa- 
tien.ts  Dr.  C\irli>le  sa>-s  (after  discussin,:^'  the  epi- 
demic of  se])sis,  and  remarkin>;  that  the  medical 
staff,  thou.Lrh  holdini^-  that  impnn-ements  were 
iietded,  did  not  l)tdie\-e  that  the  wards  were  at 
fault),  "  \e\ertheless  the  opinion  of  those  least 
(.•a])a1tle  lA  iud|j;in,u  ])revaileil,  .aid  the  lying-in 
serxiee  v.as  tala  n  from  Helle\ue."  - 

Miss  Linda  Richards,  \vh>  <  xeas  then  at  Rellevue, 
wi-ites  of  thost'  e\i,nts:  "The  mana^rers  had  bct  n 
very  anxious  for  s:imi'  time  to  take  the  maternity 
wards,  hut  the  doctors  said.  ihe\-  pn'ferred  their 
oM  nurses  to  those  in  trainini;,  and  so  they  had 
l)een  refused.  .  .  .  After  th  ntn'ses  were  finall}' 
placed  in  charge  the\-  had  the  wards  for  twenty- 
sex-en  da\-s  betore  the\-  x\eri'  mox'i'd.  .  .  .  Til. 
patier.ts  were  then  transferred  to  rough  liuilding 

1  I-'ro-.i  iiri\ato  sources. 
'Op.cil..  i>.  77. 


A  Trio  of  Trainino-  Schools        407 

Mild,  slniniie  to  .s;p,-,  there  was  ik.  nioiv  frxcr  and 
(>ii]\-  twu  deatlis,  thou-li  some  \-ery  siek  ]xitients 
had  !-ecn  transferred." 

Still  some  little  time  ela])sed  before  the  women 
comjil  -te'  the  re.i^a-neration  of  the  maternity  ser- 
\      ■•     The  Islind  (niav.  rs  w^'re  very  satisfactory 
for  lh(  >e  ])itients  who  cmld  L,a't  tlu-re,  Iiut  there 
was  no  pn'\isi..ii   fir  emer;j;eneies,  sa\-e  a   dr(...rv 
room  a'    the  ferryboat  landin.i^-,  wlirre  what   was 
possilde    had   been   ^'^ne   f -:     t-nuri;.  rir\-    ])atients 
to  ease  the    trial    by    ha\-in--   a    nnrsi    in  attend- 
ane(\     This  was  a  Nchmtary  service  on  t    e  nurse's 
part.      iMiially,  the  niana^^i-s,  haxdtiu:  \-ainIy  tried 
to  interest  a  wealtln-  ]iri\.iie  bciie\    lent  society 
devoted    to    obstetrical    relief,    but    wh.ise    funds 
>  ould   be  eiiiplo\-((i   onl)-   tor  res]    ctable  married 
Women,  wc-nt  to  the  (h'and  Jury,  and  seeun      the 
use  of  th-'  old,  dismantle']  .-nuuiediou  ■,•  which  has 
since  that  da>-  been  I'anu'l;       ;      Jl  the  -cneratiMus 
■'t    Hellevue   nurst'S   as    "The    Ihi    i-_L;ency."     The 
nurses  took  ehari,v  of  it  on  Junt'  i,;,  1877.  and  Dr. 
\\'\-Iie,  who  had  be'cn.  as  usual,  a  stn.r.L^  friiiid,  v,;is 
soon  able  to  it  port  that  its  rcsidt.^  sur])assed  tlv  sc 
"I  any  maternit\-  li'^spital  ;!i  the  country. 

The  re.scue  c"  Ik'lle\  lie  was  now  elTccted  in  all 
departments,  and  onh  needed  t^  b,.  -[je^rteeted  in 
detail.  A  recent  publicatimi  issued  by  the  man- 
ai_;ers  contains  th''  I'nlhiwinj^: 


As  the  work   liocamo  rnnsoli.latcd  in  the   hospital, 
its  influence  be^.an  to  make  itself  fell  on  every  side. 


4oS 


A  IlisloiA'  of  Xursinij 


The  (I'ictors  sfKm  ilisc(n-erfil  that  opcrati(;ns  ikact 
lifforc  alti'nii>tiil  were  pns'^ilik'.  in  i 'inscfiiuiK-e  of  the 
care  tlieir  ]iatieiits  rcceiv'ed,  and  iiniiortant  hvL,'ienie 
i:ii])r()\('ments  were  flex'ised  and  carried  out  throu_L,'!i 
the  united  infhience  of  the  hidies'  cornniittee  and  the 
Medical  Hoard  upon  the  Connnissioners  of  ("liarities. 

In  1879  tile  Stur^'es  Pavilion,  in  memory  of  tlie  laic 
Jimathan  Sturtrcs,  was  built  f^r  extreme  suruncal  cases 
!)V  his  daut^diter,  Mrs.  W.  II.  Osborn.  In  KSS2  the 
Marc^uand  I'a\ihon  f^r  women  and  ciiilih-en  was  built. 
In  1883  the  Townsend  Pa\ili(in  was  erected  for  the 
si)ecial  treatment  ui  women,  and  in  18SS  a  i)a\iIion 
was  built  by  Miss  Dehon  also  for  the  treatment  of 
women.  In  iS()i  Miss  Lazarus  built  a  juivilion  for 
the  special  accomiTiodation  of  graduated  nurses  who 
were  ill  and  required  hospital  treatment,  and  a  ftmd 
for  its  supi)ort  was  ,<;i\en  by  Mrs.  Morris  K.  Jesup  in 
memory  of  her  sister,  Mrs.  Theodnrc  (\i\ler,  who  was 
for  many  \  ears  secretary  of  the  school.  Two,  beauti- 
ful cliai)els  were  erected  for  the  Protistant  and  Cath- 
olic patients  by  .Mrs.  Townsend  and  .Miss  Lcarv.  It 
would  be  imjiossible  t'^  '/ivc  in  detail  an  accauit  of 
the  stream  of  bene\-oIence  which  throui^di  the  influence 
of  tlie  traininj^  school  has  been  flowini;  into  the  hos- 
pital durinj]^  the  past  twent\--ti\"e  years,  and  which  has 
made  the  institution  a  benedictioTi  to  the  jioor  of  Xew 
York,  'sot  only  the  hospital,  but  the  whole  vicinity 
has  chani^a'd  its  character.  The  members  of  the  com- 
mittee \vere  assured  that  it  was  not  safe  for  ladies  to 
venture  into  that  ]iart  of  the  citw  but  thev  did  so  fear- 
lessly and  were  never  annoyed;  and  as  time  passed 
the  gro.cj-shops  diminished,  the  disreputable  buildin<:s 
disa])peared,  and  now  tiie  nei_<;hbourho.  ,d  of  tlie  hos- 
pital is  liUcd  with  Hue  btiildin_i,'s.  accoinniodatiiit;  the 


A  Trio  of  Traininir  Schools        409 

schools  a:v\  other  institutions  which  form   branclics 
itf  the  hospital."' 

The  L(oneral  and    lihoral   iiitolli,L,HMK'e   displayed 
hy  tlic  L,m)un  of  men  and  Wdiiicii  who  coiKhu'tcd 
the  reforms  at  Hellevtie  is  further  att  ^ted  1)V  other 
records  of  the  vState  Charities  Aid  Association.  {  hic 
refers  to  the  maternity  ward  (juestioii.    "Our  llos- 
IM'tal   Committee   [says  the  Third  Annual  Rejxirtj, 
.It  the  re(iuest  '  »f  one  of  the  Comnn'ssioncrs  of  C!i;ir- 
n.ies,  has  reeentlv  been  eni,ra.L,u>d  in  tlic  preparation 
of  a  ])lan  for  new  maternity  wa    is.      P,ut  th*   p;-o- 
po.sed  site  is  so  ni;imfestl\-  e.nfit    that   we  Would 
iiere  puhlielv  record  (Uir  ])u  test  a-ainst  it."     Tlie 
>;!e  ])ro])o^  d  l,y  the  hos])iial,  an.]  ohjecte.!  to  1,\- 
the  eoinmittee,  wa^^  sjjceified  as  l.ein-  too  cl,,x,.   to 
the  hospital,  an<l  jr  t  i.  .rt  h  of  the  n,..roue  ;md  the 
dis.seetioii  rootns.      It  was  ultunati'ly  ahandoncj. 
The  otlier  refers  to  the  liMSjiita!  as  a  \\h.ile,      (u 
1S74  the  State  Charities  Aid  Ass.ieiatiou  prcseiiteij 
a  rejiort  reeommendini;  the  rcliuildin,^  ,  ,f  DcH^.vue 
on   the  ^^rounds  of    its  defecti\-e   ventilation,   !.ad 
eonstruetion,  .and  the  e.Mstenee  of  ].\a'ima.      The 
report    eont.ained    e.\hausti\c>    .statistics    and    v,is 
aeconii)anied  l,y  a  stron-  letter  from  Mi.ss  Louis.i 

Selurvlcr.      With    ,u 1    mn-sin,L:    ;md    cleanliness 

l)\-;emia  soon  dis;.ppc,,red,  Imt  the  structural  dis- 
ad\-,intai'('S  of  (he  hospital  li.ive  liccii  ackiiow- 
!<  d-,'ed  bv  a'l  sul.scijuent  critics,  and  tlie  l.uildini: 
:•  ni)W  (i.)07)  on  tlu  e\e  of  hieing  replaced  by  new 
■tructurts. 

'  History  oj  the  Establishment,  cii. 


4IO 


A  History  of  Xui'Ming' 


In  the  sinniiTT  of  i^.j(>  ihc  scIkimI  list  the  stT- 
\ices  111"  Sister  Helen,  who,  \"ith  iinpairn".  h.'alth 
and  otlier  o'l.liL^ations  1/cfori.'  lur,  rrturnt'd  to  Eivj;- 
land.  Sht>  had  ])laet'(1  the  sehi  h  i]  on  a  firm  liasis, 
made  it  inchspensalile  to  ih.^  hnspitah  and  had  he- 
i,nin  til  srnd  ot-.t  trained  wi.nirn  to  extend  the  new 
.system  and  tcaehniL;.  !ler  juipils  were  read\'  and 
aMe  to  t'  aeh  nursin;^",  l)ut  none  of  thmi,  -[jmhahh-, 
^\'iuld  lia\e  been  ahle  to  eo]H'  with  the  midereur- 
reiits  ot'  ojiposition  atid  enmit\-  that  still  sous^ht 
c\er\-  o])])ortuiiity  oi"  underminin;.^^  tin-  authority 
of  the  su|>rrintrndent  of  nursi'S,  as  Sister  llcleti, 
fi'oin  her  Liri'at  >  \])erunee,  was  aMe  to  lio.  Onh' 
those  who  ha\e  nut  eornt])t  pohtieal  inllaenee  in 
hospitals  know  \\h,it  this  etunit  .  is.  iler  suet'es- 
sor.  Miss  I'diza  I'lrkins.  th'ia',,di  iii  t  a  nurse,  and  of 
a  eharaeter  tnilike  Sister  lii'liu's.  ne\  t^r' heless 
]X)SSessed.  the  skill  and  aliilit\  neeiK<]  f>  w  tin  jiosi- 
tion,  and  slie  was  seleett  d  as  the  he.id  of  the  si  hool. 
Sister  lleKn  eriiund,,'d  lu-r  thorou.,hly  iPi  all  the 
princi])les  of  disei])hne,  order  of  seniority,  division 
of  authorit_\"  and  re^p.  lusihility,  an<l  jfcncral  :nir'- 
in.L,'  elliie.s,  as  well  as  the  eti'imtte  invol',a'(I 
in  the  sueeessful  amniTiistratii  mi  of  ,i  hos])i- 
tai  Irainiii;.^'  course;  and  admiraiih-  ilid  Mi.ss 
Perkins  apply  them  duriiij;  her  iiiteeu  3  ears 
of  rule. 

Sist(.'r  Helen  sailed  !"or  i'hijdand  Itaxini;  l.elnnd 
her  th''  lolliwin;;  letter  of  farexVell  for  the  tuu'ses 
for  whom  she  hadi  done  so  muidi  aii'  i  li\  w  hom  she 
was  so  '/reatl\-  esteemeil: 


A  Trio  of  Tniininir  Schools 


411 


Till':   TK.MMXC.   sen 


<  )01. 


;i4 


I-ast  26th  St  ,  Mav  1st. 


1S7O. 


To  Ti!K  Members  oi-  tiik  'IkAinixc  Sciiooi.. 

Dciir  I-'riciuis  ill!,!  Fcl/<':,'-\\\,rl,'ci:s:~l  iiai]  ijuitr  in- 
tdi.kMl  til  haw  a  little  talk  with  yim  this  l'Wuuv^  and 
\Msh  \(.u  all  .iiodd-hycLul  I  am  stujiidlv  weak  and  niav 
v.,[  ■,)(_'  d.le  t(»  hear  it,  Sm  I  wii;  write  you  a  liAini,^ 
ta.  V  ■'  I'ii  instead. 

May  (lod  liless  you  all,  and  [irosper  \-(min  your  work, 
anil  j^ive  you  the  ,i,M-aee  of  icrseverance.  So  <ar  you 
have  done  noMv.  Ti)-da\-  coinpletes  our  first  three 
>-ears.  I  lo,,k  baek  on  the  past  with  .e-reat  thankful- 
ness for  what  has  been  aehieved.  'i'hree  \-ears  aLTo  we 
'oninieneed  what  was  by  many  thou,t,dit  to  be  a  doubt- 
lul  unde^takin,!.,^  Xow  the  trainim,'  se|].„.lisa  tlour- 
ishin.L;  institution,  standin-  well  with  the  pulilie  and 
\-alued  b>-  those  i)est  able  to  judj^'e.  the  niedieal  statT 
at  Bcllevue  and  the  employers  of  our  pruale  nurses, 
I  endeavoured  to  estabb'sh  the  work  on  a  ri'^ht  founda^ 
'•'^''i-  The  ladles  of  the  (omnntte  ha\e  doiie  all  in 
Iheir  jio^ver  to  ad-aiiee  it.  JUii  all  this  would  June 
bei  n  of  no  a\ail  but  for  the  earnest,  self-saerilitini.,' 
'A  .:k  of  the  nurses.      May  the  si)irit  lonj,,'  live. 

Xow  I  leel  I  lia\-e  ..Illy  to  thank  those  most  who 
ii.cebeen  witii  us  l-mj^'cst.  A  \'vw  in.. re  words  and 
i  am  d.i.ie.  I  thank  you  lovintjly  for  the  atfectionate 
sMUjiathy  you  have  shown  me  durini;  my  illness,  the 
v., IV  you  have  done  your  duty  with  little  trouble  to 
Miss  Van  Rensselaer  and  have  let  me  alone.  Onee 
more  poocl-hye  and  God  bless  ycju. 

I  h..,if  when  ytm  read  this  you  will  not  say, 
"Si  -er  speaks  as  if  we  were  never  to  sec  her  apain." 
Only   remember  partinjj    is   eertain,  meeting  always 


412  A  History  of  Nursincf 

'iuiil.t  fill,    especial!)-    \\h-n    one  is   in  ill-health  and 
.•;lM)Ut  to  cross  the  Atlantic. 

Sister  IIklkx  of  All  Sai\ts.' 

The  Massachusetts  (leiieral  Hospital  of  Boston 
was  lhi>  next  of  the  liio  of  _L(eiieral  liospitals  to 
o]ien  a  sehoMJ  for  nurses.  Tlie  "llistorA  A  the 
Iliston  Traiiun,^  School"  puhjishcd  as  ;,'  ])art  oi 
t!ie  annual  rc'])()rt  in  kjo-i,  sa\-s: 

It  is  to  tlie  Woman's  IMm  ational  Association  we 
owe  the  suL'i^rc-.tion  (if  a  nee<l  in  Boston  of  a  t  ainin^ 
school  for  nurses,  'i'lie  matter  came  iiu  for  discussion 
at  a  mcetinj,'  held  in  April,  1S7.;,  and  the  first  practi- 
cal ste])S  were  taken  toward  the  f  luniiinj,'  of  a  system 
now  so  Well  i-ecMt:nised  not  onl\-  as  a  means  of  educa- 
tion for  wninen,  Init  as  a  necessity  to  meet  the  de- 
laands  (;t  tne  ei-nmumity. 

Tile  Seeon  I  Annual  Report  of  the  Woman's 
I'.dticational  Asm ieiali(ni  ij;i\c-s  more  ful' \- the  \-ery 
first  ste])s: 

A  iiieetini,'  was  called  as  early  as  June,  1872,  to 
consider  the  subject,  and  it  was  made  a  special  <il)jeet 
of  discussion  ni  two  or  tlu'ee  meetings  durinj,'  the  next 
autumn.  In  tlie  winter  ot  i,S7 ;;  a  member  of  the  com- 
mittee hcird  of  the  exec  Ih  ni  school  for  nurses  which 
had  been  established  in  Xtw  York.  She  made  a  visit 
there,  and  satisficfl  herself  that  tlie  ])lan  was  a  wise 
one  and  would  succeed.  The  report  induced  the  com- 
mittee to  believe  that  the\'had  really  f -und  w'lat  they 

•■  Sister  Hilon  later  k;ivo  liistin^uishcd  service  in  the  eoloni.il 
w.irs  of  Ivnirl.ind.  After  one  such  eainpaij,'n  she  returned  lu 
her  hotiir  .111  1  die-J  in  the  elosintj  years  of  the  century. 


A  Trio  of  Training-  Schools        413 


iKi'. 


L'cn  so  long  scekiiij^'.    T 


c.ilcd  a  parlour  meet 
ing  in  order  to  consider  tlic  subject  more  full\-  and  to 
interest  pers'  ns  nutsirle  ol  tlu.  association  in  tiic  plan. 
This  meeting  brought  out  the  expression  of  so  much 
inten  t  and  so  much  svnipath_\-  with  tiic  movement 
that,  thouidi  the  difficulties  of  the  undertaking^  were 
seen  t'.  i)e  ..  cat,  the  committee  rcpcjried  in  faxour  ot 
it  at  the  regular  meeting  of  April  lo.  and  recommended 
!hat  it  should  be  committed  to  the  charge  of  wche 
iadie-  and  gentlemen,  who  should  or  ranisc  it  and  carry 
it  'in  mdependentl'v-  of  this  associaliun.  In  conse- 
'juence  of  tliis  action  a  circular  \va^  ent  out  summon- 
ing a  meeting  of  all  those  who  were  interested  either 
for  or  against  the  training  of  nurses. 

The  meeting  was  held  in  .May,  iS;;;  and  was  large 
,ind  representative.  There  were  those  who,  witlmut 
knowing  how  such  a  re\-olution  was  to  be  brought 
about,  were  eager  for  the  day  when  this  new  order  of 
i)eing,  a  trained  nurse-,  was  tf)  be  had  iny  the  asking 
.and  pay;  tor  it  must  be  remembered  that  it  w.-is  not 
'inly  the  quality,  but  the  quantity,  thac  was  lacking, 
and,  literally  speaking,  the  whole  of  a  long  day  scjine- 
times  had  t-i  br  spi  iit  in  lM,,king  f,  .,•  ;,  n  liable  nurse. 
There  were  n(jt  many  physicians  present  :  a  few  came 
tM  watch  i)roceedings.  some  to  speak  not  unfri(ndly 
words,  though  rather  an.xious  ones.  Dr  Susan  Dim- 
ock  Ra\c  emouragcment  with  most  delightful  voice 
ir  I  manner.  The  upshot  of  it  all  was  that  a  c  onniiit- 
lec  was  fcjrmcd,  and  then  the  work  began  .  .  .  Hrst 
to  decide  upon  a  i)lan,  to  ask  for  the  ^o-operation  of 

piiysicians,  and  to  raise  money \  letter  was  sent 

til  the  trustees  of  the   Massachusetts  (leneral  hospital 

-king  their  permission  to  establish  the  training  sc  liool 

ill  connection  with  that  hospital.     The  answer  seeming 


4'4 


A  History  of  Nursini,'" 


laMHirahle  to  the  plan,  a  conference  was  arranj^'ed. ' 

The  trustees  rc^p'  iniled  witli,  <  'U  the  \\'\v  ile,  k'''*-- 
if\'in<j;  reacHncss,  thoui^h  the>"  held  oil  a  hlt'.e  Avarilv 
from  the  p(issihiht\-  of  interference  witli  tlieir  au- 
thuritw  The\"  i)roposc(l  plaeini^r  two  wards  in  the 
care  <j1  the  tramini,^  schofl  enmniittee,  'out  under 
the  ff)Il'Aviny;enn(htions:  that  the  relaticii  l)et\veen 
hospital  and  school  should  continue  during-  the 
]ileastn-e  of  the  trustees;  th.it  the  st'hool  should 
lak(.'  on  as  ])upils  sut'h  nurses  th"n  emplo\'ed  in  the 
wards  as  the  trustees  wished  to  relam;  that  the 
nurses  and  piqn'ls  of  the  school  should  not  attend 
the  pati(>nts  of  the  hospital  without  ])re\ious  in- 
struction in  nio\-in<^r  mid  cariti^  for  bed-patient-^; 
that  niu'-^es  should  ai,n"ee  to  remain  for  at  least  two 
years,  hut  that  the  trustet's  reser\-ed  the  rij^ht  to 
discharj^^e  them  front  servin  in  the  wards  tor  suffi- 
cient cai,.,e  ,  tliat  tlie  sui)ernitendent,  nurses, pu[)ils, 
and  all  persons  em]>loyeil  b\'  the  school  shoidd  he 
imder  the  tneiiicil  jurisdiction  of  the  jihysicians 
and  surj^jeons  (and,  of  cotu'sc,  suhiect  to  th"  rules 
of  the  trustees),  ,ind  tiiat  "no  instnu'tion  of  or 
itilert'creiUH'  with  -^,lid  ])ersons  within  the  hospital 
shall  l>e  ]n'vniittel  without  eoTisent  of  such  ]ihvsi- 
cians  and  sur.^eons";  that  waives  shouf!  he  paid 
\)\  the  hospital  ,ind  not  I y  the  schoi  A,  and  that  the 
di:ties  of  the  su])erintendent  should  n>  >t  conflict 
with  those  of  the  matron. 

>  "  Karly  His*'--y  '  tin.-  Boston  Tr-  initio  School."  Iiy  >trs 
Curtis  ;in(l  Miss  Doi'ny,  nu'tnlifrs  oi  the  oiiv;inal  bounl.  Tht 
Aiii,  r.  Joiirii.  uj  .'>  ursiHn,  February,  I'joi,  p.  jji. 


A  Trio  of  Training  Schools 


415 


The  training  school   committee,    flndin.ir   these 
rcK^-ilations  leaned  a  little  Un,  far  in  faxour  of  the 
tnistees,  offered  to  accept  the  responsibility  for 
the  Avards  and  the  nursii\>(  provided  the  trustees 
were  willing;  to  modify  some  of  their  conditions — 
amon.cr  others,  that  the  school  also  have  the  right 
to  terminate  the  connection  with  the  hospital,  not 
less    than    two   months'  notice   beii^-T   re(iuired    in 
either  case;  that  the  director  of  the  scliool   also 
should  ha\-e  the  right  to  discharge  anv  nurse  or 
I)upil,  and   that  the  word    "interference"  should 
not  l)c  held  to  ap])ly  to  the  rules  and  disei],'line 
which  (sul>iect  to  the  regulations  of  the  h'ispi!;il) 
the  directors  might  judge  ni'ccssarv  for  ihr  i:o(;d 
go\-ernment  of  tiie  school,  nor  an\-  \-isits  of  direc- 
tors made  to  inform  thei:isel\-i>s  of  the  condition 
<  if  the  school. 

These  moditieation.;  wt^re  e\-identl\-  agn'edi  to 
hy  the  trustees,  for  tlie  tmining  school  committee 
now  srt  to  Work  in  earnest,  raised  tlu'  money, 
rentt'd  a  house  for  tlie  mn-ses,  and  undertook  to 
l)e  read\-  hy  the  ist  of  Xo\-emlK'r  to  take  charge 
of  the  wards.  Short  as  was  the  timr  alloux'd, 
the  committee  n-  '<  its  ohli.gations  to  the  daw  an.l 
with  a  su])eriiiten(!(!it,  two  head  nursrs,  ;!nd  four 
]n]])ils,  took  charge  of  ns  two  v.ards  on  the  ist 
o.f  X(;vember. 

The  hospital,  ni  its  interior,  and  its  former  nurs- 
ing scr\  ice,  was  very  diiTerent  from  Bellevue.  The 
M:issaehusetts  (Icncral  stood  with  such  institutii  ins 
:s  thr  Xf\\  York  and  Pennsylvania  hospitals,  and 


J 


410  A  History  of  Nursinj^ 


all   nf  its  arranpjcments  were  equal  to  the   best 
k!i!)\v!i  at   that  time.      It  was  clean,  bri>j;ht,  ])leas- 
ant,  and  the  coinfi  rt  of  ih.'  patients  was  consid- 
ered   in   every   way.      It  was  already  historically 
iiiil^ortant  as  the  scene  of  the  first  major  operation 
pirfornu'd  under  tlie  inlluence  of  etbc",  for  it  was 
theve  that  Morton  ha.d  demonstrated,  on  October 
16.  iS4(),  the  discovcy  of  ana-sthesia,  havini,^  ])re- 
vi.iiislv  rxi)erimente'i  u])on  him.self.     The  Massa- 
ehusctts  (ierural  was  noted  for  the  dignity  and 
retinenient  of  its    operation-room  work,  and  for 
white  linen  coverin-s  of  esjK'cial  i)urit}'  and  tine- 
ni'ss.     The  W(  nnen  wlv  >  had  w<  .rked  there  as  nurses 
were  of  a  hi-hly  estimable  type,  ;j;ood,  conscien- 
tious, and  faithful.     An  account  of  the  early  days 
in  tlie  hos].ital  by  one  of  Us  matrons  makes  this 
faei    \er\-    clear,    e\-en    if    there    were    n(.)t    other 
testimony.' 

The  condit  ns  were  not  very  comfortable  tor 
the  nurses.  Miss  Slurtevant  had  entered  the  hos- 
])ital  as  assistant  nurse  at  seven  and  a  half  dollars 
a  week  in  iSoj.  TliC  nurses  slei)t  in  little  rooms 
'  etwi'en  the  wards,  twn  in  one  bed,  which  was 
folded  out  ..f  the  way  by  day,  for  the  room  ihen 
became  a  jMSsa'^'c.  or  eonsuUin,L,'-room,  or  even  a 
])lace  for  dressin;j;s  and  minor  oiieratious.  'I  h, 
hours  mu  .luty  wt-re  from  live  In  the  mornin-  to 
half-iiast  nine  in  the  evenin-,  with  an  occasional 


1  "  Persnn.il  Ree..llcotions  of  HospUuI  UL-  before  f.ic  Days 
nf  Tniinin.L;  Seh.M.ls."  by  V..  L.  Stiirtcvant.  The  Trattud 
Xiirsc,  UccemlKT,  1895.  pp.  287-291 


A  Trio  o<"  Training:  Schools       417 

o 

hour  olY.  The  nurses  had  a  dark  and  din,c;y  dininc^- 
rooni,  with  i)t.'\vti'r  lumbUTs  and  other  fitlini^^s  to 
match.  There  was  no  hierative  private  ihity  to 
look  to,  as  nursini^  \v;.s  consid.fred  to  l)e  an  (n'eu])a- 
tion  onlv  suital)le  for  elderly  females.  .\\\-erthe- 
less,  man\'  excellent  women  served  conscientiously 
in.  the  hosjjital  for  years  at  a  time.  There  wi're 
eleven  head  nurses  and  about  sixteen  assistants, 
1  )esides  "  ni.^^ht  watchers."  The  wa>-  the  W(  >rk  was 
arrant^ed  was  very  crude  and  was,  inileed,  inlier- 
ited  from  earlier  centuries.  For  instance,  all 
soiled  lini'n  was  first  washed  ly  the  nurses  in  the 
A'ard  bath.-roonis  ht'fort.'  l>ein,L;  sent  to  t!u'  launih'w 
.Miss  Richards  has  described  the  curious  rota^inn 
of  service — how  each  nurse  had  a  round  ot  dut\- 
from  ward -work  and  theca/e  of  ])aticnts  to  a  turn 
it  the  washtubs,  and  how  te>naciousl_\-  tliis  custom 
was  cluiii,'  to.  Xothint^,  howewr,  could  better 
illustrate  the  differi'iit  character  of  the  old  nursinjj; 
svsteni  and  the  new  th;m  the  .vtor\-  which  is 
related  bv  this  same  veteran  pioneer : 


In  one  of  the  bu-.tze  hi^si-itals  where  I  was  nrcjanis- 
inc;  a  trainin.u  sehdnl  n  thdsc  earl\'  days,  betorc  I  had 
really  taken  hold  of  tl^.o  work,  but  was  tindinj,'  niy 
bearin.sjs  before  making'  chan^'i'S,  T  was  inakin.i.;  rounds 
Mne  niornin.i,'  whi'ii,  ui)on  entering,'  a  war  1,  I  saw  at  a 
ijlancc  thai  a  man  in  a  bed  near  the  door  was  dyinj,'. 
Tlir  nurse  stood  near,  in  '"nil  view  of  iho  man's  face, 
i]uiet]v  doin.L'  Iier  morniiii:  ckistiiiL;,  and  doin^;  it  well. 

r  sleppei]  to  ti,e  bedside,  examined  the  |ia1anl's 
liube,  wiped   the  dampness  from   Ins  face,  and  then, 

viiL.    II    --J7 


4i; 


A  History  of  Nursing 


<r,MTT.'  back  in  the  nurso.  wlin  was  stiU  <lustin.<:  I  in- 
f|uia''!.  "H'AV  Iciil:  has  iliis  man  been  in  this  condi- 
tion?" Slic  lookcil  up  with  a  very  blank  expression  on 
her  face  and  asked.  "What  cond.lv  inr  "  I  said,  "Do 
you  not  kn.iw  tliat  the  man  is  d\in-:'"  She  answered 
wit  li  surprise.  "Why,  no."  I  instructed  her  to  sen<l  for 
thi'  doctor  a;  oiue,  I'kice  screens  around  the  bei',  and 
to  stav  with  tlie  patient  as  loni;  as  he  lived,  and 
])assed"  on.  Later  in  the  dav,  when  I  made  rounds 
auain,  the  nurse  came  to  m(}  aivi  said.  "  ^Hss  Richards, 
wiaild  vu  mind  tt'llni,^'  me  h"\v  you  knew  that  man 
wa■^  d_\-inc?"  I  asked  her  how  lor,;.,' slie  had  been  in 
that  war<l,  and  she  rejoed  two  years.  Tlun  I  said  to 
her:  "X^u  have  been  in  this  ward  all  that  time,  with 
]iatients  comin.Lr  and  ^i.in^  and  w'wh  some  dying:  will 
\-ou  tell  me  how  v<'U  can  ha\e  been  hue  so  lon<,'  and 
'K/l  know  when  a  man  is  dyiiiLr?  1  will  tell  y(<u  how  1 
know:  bv  carinir  lor  my  'patimts,  by  carefully  watch- 
im:  them  and  ob^crvin.i;  the  chan.i^'cs  from  day  to  day 
and  fnim  h,- 'Ur  to  Ivur,  by  bein,^  interested  in  each 
one  as  a  human  bein.^r  cntnisti'd  to  my  care."  This 
will  Ri\e  some  idea  of  the  (jualiiy  of  the  nursin<,'  before 
trainiiiL;  sciv  lols  were  orL;aniseil.' 

Thc'  first  supcrintcntlciit  of  lutrses  was  .Mrs.  Bill- 
iniys.  w!i(i  h:id  had  cxiu'ricncc  as  a  h(>s]>ital  nurse 
(Itirini:  the  Cw'A  W;ir.  Sister  Ilt'len  oi  Ikdlcvuc 
was  a]>])caled  !< .  to  [[Wv  Mfs.  I'ddinijs  some  insi<,dit 
into  tr:iiiiii!'-:  sc'lmo]  niinKi^^n'ment,  and  with  some 
rehtctancc.  li:isrd  mi  tlic  slinrtnoss  i '1  the  time 
allowe<l   iicr.  consented    to   l;ivc    her  two  jnonths' 

1  "Thirtv  Years  of  Proi^ress,"  by  Liml.i  kichanls.  A)iuri- 
am  Jniiriml  oj  Xiirsiiii;,  January,  1904,  jip,  26^2(17. 


A  Trio  of  Traininij  Schools        .;i9 


anu 


rxpcrifiKc.  Mrs.  Hillii\L:s,  Ikawxit,  only  hdil 
lur  i>iisitinii  a  few  montlis,  anil  was  siuTci'dcd  l)y 
Mrs.  Marv  vn  Olnhawsrn,  a  woman  i>f  hi.L^lilx' nrij^r- 
iiial  and  j)icliircs(|uc'  characteristics,  whn  liad 
served  as  a  sort  of  free  lame  throut^h  our  own  ei\il 
and  tb.e  Franco- Prussian  wars,  and  who  has  lett 
an  entertaininij;  account  of  hei"  dramatic  career.' 

Thou,L,di  Mrs.  von  C>ln!iausen  i)ro\-ed  to  he  too  im- 
])uls  \-e  and  individ'j  distie  to  be  a  succt  -stul  head, 
not  haxin.L;  had  the  kind  'if  trainin.LC  necessary  for 
the  enforcement  i'(  disci]'hne,  the  trainin;.,'  school 
committee  ilid  not  lost'  courage,  alth^ 'Ul;)!  the  suc- 
cess of  tlH'ir  ex])eriment  hun,L,r  for  a  time  \\a\-erini,' 
in  the  balance. 

The  nnvlical  staff  from  the  lie'^M"Tmin^  had  not 
wanted  the  school.  Tin  ;.'  ])referred  their  old- 
fashioned  nursin;:  sNstem  and  the  old  untrained 
mirst's,  and  when  the  wanls  und.er  the  new  ar- 
ranL,H'ment  did  not  run  smoothh'  the  school  was 
cotisidered  to  ]>c  \hv  whole  cause  of  trouble.  Im- 
nally  the  trustees  told  the  trainin;^^  school  com- 
jnittee  that  if  they  could  ])lace  a  jrraduate  nurse 
in  char^^c  the  school  would  be  [.nwu  another  yt'ar's 
trial,  but  if,  at  the  end  of  [hat  time,  it  had  not  \-et 
been  ])roved  to  be  of  real  \'alue  to  the  hosjiital,  it 
would  be  ^i\-en  u]).  At  th  s  cnbeal  juncture  Miss 
Linda  Richards  was  ])m  in  char-e,  and  from  her 
advent  date  the  real  jiro-ress  and  success  of  the 


.Ijikti- 


f  AdiviU:tr.'^  oj  an  Arutv  Xnrsr.  hv  Mary  von  Olnliansen, 
v:\i\.ci\  by  James  PhiniU'y  .Muih'K'.  Liitlo.  lirowii  &  Co,. 
Boston,  1005. 


MICROCOPY    RESOLUTION    TEST    CHART 

ANSI  ond  ISO  TEST  CHART  No    2 


1.0     S -  III- 


i.l 


2.2 
2.0 


.8 


1.25 


1.4 


1.6 


^      ^Ri^LiEn  iNA^GE     Ir 


4-^o 


A  History  of  Xiir^in;/ 


iK'W  .systfin.      I  kr  own  rcollcc'tiniis  "I"  that   time 
arc  full  I  )t"  interest .     She  says  . 

On  the  one  hand  llie  coniniitlee,  a  1  oil  vol  l)ravi>  men 
ami  women,  foui^ht  for  the  school,  and  nn  the  other 
the  physicians,  witli  two  exceptions,  were  against  it. 
Between  the  two  stood  the  trustees.  I  tnlly  realiscil 
that,  if  I  failed  to  prove  that  educated  and  trained 
nurses  were  superi(jr  to  uneducated,  untrained  ones  a 
death-blow  would  be  given  to  the  school  in  that  iios- 
pital  and  serious  injury  would  be  sustained  by  tlie 
movement  generally. 

In  nrder  to  make  a  record  for  the  cause  Miss 
Richards  took  charjijc  of  all  special  nii^dil  duty  and 
gave  her  personal  attention  to  all  serious  cases,  in 
ad<lition  to  carr\in}j;  out  her  <j;eneral  duties  of  su- 
pervision and  teaching  as  superintendent.  She 
writes : 

I  was  blessed  with  an  extraordinary  amount  of 
strength,  could  endure  hardship  well,  and  possessed 
a  h<jpcful  disposition,  so  I  was  able  to  do  plenty  of 
work  iji  a  suHiciently  good  quality  to  i)rovc  the  supe- 
riority of  the  new  o\er  the  old.  My  Hrst  happy  day 
there  was  at  the  end  of  three  months,  when  the  super- 
intendent of  the  hospital  ti'ld  nie  that  the  trustees 
had  voted  to  give  the  school  anotiier  ward,  and  added  : 
"  The  school  is  safe.  Before  another  year  comes  round 
you  will  have  the  nursing  of  the  entire  hospital  in 
charge."  It  so  proved,  and  gradually  the  medical 
RtatT  came  to  feel  that  trained  nurses  were  valuable; 
one  bv  one  they  became  Hrm  friends  of  the  school,  an<l 
at  the  end  uf  my  first  year  the  trustees  adopted  the 


A  Trio  ofTrainin*^  Schools        421 


school  as  a  part  of  the  Iiospital,  with  a  committee  of 
its  own.  We  had  a  small  but  comfortable  home,  and 
ft'lt  that  we  stood  upon  firm  L^'roimd. 

Miss  Ricliards  stayed  there  twD  and  a  half  vears, 
and  then  went  to  lui^laiid  to  stud_\-  tiainini;  scdiool 
methnils  there.     Slie  eontinues: 

For  tlie  last  year  and  a  half  tlu-  wheels  ran  \-ery 
smoothly  nideed.  1  ha\e  ni  \er  worked  with  a  nore 
loyal,  helpful  crmmittee,  ami  but  for  their  help  and 
sujjporL  those  fn-st  months  would  have  been  \-er\-  hard 
lo  live  throu,L,di.  They  were  not  hajipy  at  their  best. 
I  seldom  look  back  upon  them.  I  seemed  to  meet 
hostilit\-  oT  all  sides.  We  wi  re  li\in<j;  down  a  stronj; 
prejudice.  We  suffered,  I)Ut  we  conquered,  and  I  am 
},dad  tliat    I   f'4ii,'Iit  that  fi.ulit." 

From  here.  ha\iiiL,''  jilaetd  the  sehonl  on  a  firm 
foundation.  Miss  Rieiiards  wriit  to  St.  Thomas's 
hosj)ital.  MnLilaiid,  where  slu'  was  ])erinilted  to 
s])end  eiLjht  \veeks  in  \-isitint^  wards.  assistiiiL:  with 
Work  or  iitit.  as  she  ehoso,  and  witnessiiiL:  "pcTa- 
tions.  Her  experieiiees  there  were  \-er\-  interest- 
in':;.  She  met  many  of  the  womiii  who  were 
notable  in  mirsini,'  work,  and  tells  the  following 
HUlo  anecdote  of  Miss  Xit;htinjj[ale: 

I  had  l"<ii  in  the  "home"  less  than  a  week  when 
an  imitation  came  from  Miss  Xi},'htinj;ale  for  mc  to 
visit  her  in  her  London  home.  Shall  I  ever  forjjet  the 
excitement  that  invitation  caused?  .Miss  Crossland 
told  me  Miss  Xi^htinKale  would  ask  my  opinion  of  the 
<litTerent  nurses,  both  ladies  and  others,  and  I  could 
sec  that  there  was  a  little  an.xiety  felt  eoncerninjj 
ihc  answers  I  might  j.,M^  *"      T  \\»nt  on  the  appointed 


4^ 


A  History  of  Xursiiu^ 


day  and  must  say  I  did  nr)t  foci  quite  at  my  ease  as 

the  maid  took  mc  to  Miss  Xi.fjhtinyal-j's  nxmi,  but  one 

look  into  those  kind,  clear-bhu'   i  yts  and  the  liearty 

j^n-asp  of  tlie  little  hand  quite  set  me  at  ease,  and  before 

I  knew  it  I  was  talkin^,'  as  freely  to  her,  who  had  done 

more  than  any  woman  livint,^  to  alleviate  sut"ferin<,^ 

as  I  wouhl  have  to  a  life-Ion^  friend.      Miss  Xij^ditin- 

gale  was  lyin;,'  upon  '. iie  Ijed  (I  ha\e  never  seen  her  in 

any  other  position,  th-ju^h  I  afterwards  had  the  very 

<,'reat  plea., are  and  honour  of  vi.sitin[,'  her  a  few  days 

in  her  beautiful  country  home).     She  was  dressed  in 

black  and  on  lier  head  she  wore  a  very  becomin,^  cap. 

Miss  Xij,ditinj,'ale  said.  "I  am  very  j^dad  to  see 

vou  and  talk  of  the  trainin;^'  schn..]  work  in  America." 

She  asked  me  much  in  lU-tail.  ami  cantiiU)    wrdf  all 

down.      When  I  r<  tunud  tn  the  ho>i)ilal  the  (pieslions 

were  numerous:  "What  did   Miss  XiK'hlinuale  sa}'" 

•'What  did  she  want  to  know'"      But  had  she  asked 

me  for  criticism,  which  she  did  not.  I  couM  lia\f  tuuiid 

none,  and  as  1  look  back  to-<la\-  1  can  think  n{  wmc.  .  . 

I  went  from   Ivlinbur^h  for  a  few  days  witli   Miss 

Xij,ditini,'ale  and  received  from  her  words  of  t'uc  oura^'c- 

ment  which  have  lasted  all  these  years.      In  "Ue  "i 

her  letters  to  me  just  as  I  was  leaving'  Enj,dand  she 

bade  me  and  our  profession  Godspeed,  sayinK^   "Out- 

stri])  us,  that  we  in  turn  may  outstrip  you  a^'ain."' 

Miss  Linda  Richanls  has  h.id  :i  rarely  extensive 
and  useful  career  as  a  nurse.  On  Iter  return  from 
Ivn^'land  in  1878  she  organised  the  training  sch<«il 
of  the  Boston  City  hosiMtal.  In  188;  .she  was  sent 
by  the  American  Hoard  of  Missions  m  Tokio.  Ja- 

'■•  KecoUoctions  of  a  Pioneer  Nurse,"  by  Linda  Richards. 
Aiiii-rhaii  Jotiriuil  of  .VHrsi;;^;.  January,  oio(,  pj)  3a><.  252. 


A  Trio  of  TrainiiiLf  Schools        -i^:-, 


pan,  where  she  oryjanisccl  a  school  tn  train  Ja])an- 
(.'se  nurses.  I  )n  her  return  she  orL;ani,>e-il  thv^'sehool 
of  tile  Methodist  hospital,  I'hiladeljjhia,  and  in 
i8()^  Was  eallt'd  to  her  dliuj  .natcr  as  sujjc  rintend- 
erit.  Miss  Richards  has  li(>eTi  enntinualh-  called 
from  one  hos])ital  to  ;inotlHr,  cithi^r  to  ort^anise  a 
new  school,  or  to  build  uj)  one  that  A\as  undevel- 
o])cd.  In  tliis  way  she  has  '^\\vn  ser\  ice  at  the 
1  lonK'opathie  hospiial  of  I'r'iokh-n,  the  Ilartfonl 
hospital,  the  University/  hospital,  I'hila  ii  Ijihia, 
and  then  hcLjan  a  series  of  rcL^cneratiw  ser\  ices  in 
hospitals  fur  the  insane,  lie^innini,^  with  that  at 
Taunton,  Massachusetts.  iUr  success  in  creatini^ 
a  new  ideal  ami  diw  lopini^r  iTii]>in\rd  s\'sten'is  of 
nursiiiL:  in  tliesc  hospitals  has  ]» 'en  so  distitiLruished 
that  here  to<i  shr  has  1  iccn  called  frmn  o!ir  post  to 
another  ti  1 1  irjjanise  and  teach. 

Till-  ("oinu'cticul  Traiin'nL;  ScIiom],  (ipiiied  in 
New  1  Ia\en.  w.is  the  last  c  ,f  the  dist  in-uislied  trii  >, 
thou-h  it  had  ohtaitied  its  thaitir  luf  .rr  the  i'x  IK- 
vue  school  had  one.  A  notaMe  feature  in  tlir  in- 
ccj'tion  of  this  school  is  the  prominent  part  taki'U 
hy  men  in  hrinsj^in!.,'  about  the  new  st\-l('  of  mu'sint;, 
thou.!.,di  in  XfW  lla\-en,  too.  a.s  well  as  in  other 
places,  the  acti\'t\-  of  the  wo^iun  duriuL^  thr  ("i\  il 
War  hail  pernu-ated  all  society  with  new  standai'ds. 
The  manat^ement  of  the  hospitals  thr()u.!.;hout  Con- 
necticut Was  larj^'cly  in  the  hands  of  the  Cieneral 
Hospital  Society  of  Connecticut,  a  (li}.,niifie(l  and 
weighty  body  that,  in  1S76,  celebrated  its  scmi- 
centenni.il.      This    socictv    first    considered    the 


4-M 


A  History  of  Nursing 


subject  of  trainin;/.  Its  own  rec(  )r(ls  arc  very  brirf . ' 
but  \V('  sliall  (luotc  Mrs.  Francis  Bacon's  history 
of  the  foundation  of  the  Connecticut  Trainin,:^ 
Schooh-  oniittin<.f  onh'  her  j.)rt-'ainble. 

The  <,'rcai  need  lor  nurses  seems  lu  liave  impressed 
the  gentlemen  of  ttie  Hospital  Society  as  early  as  1S72, 
a  year  before  we  had  tliout^dit  of  the  matter,  ami  at 
Iheir  annual  meeting,  .^hly  tlic  ';lh  of  that  war.  they 
discussed  the  subject  and  appointed  a  committee, 
"consisting  of  Drs.  While,  Jewett.  and  Daggett,  to 
inipnre  and  r(.'iiort  on  the  practii'ability  ot  makini: 
the  hospital  available  as  a  training  school  for  luu-scs." 

Before  the  connniltee  had  time  to  report  to  the 
Hospital  Societv  in  the  sjiring  of  1S7;,  .Mr.  (diaries 
Thompson,  of  this  city,  who  in  his  own  tamd)-  li.ad 
suffered  from  the  ignorance  of  the  old-fasliioni'd  nurse. 
and  who  was  familiar  with  the  Kuropcaii  s\-^iem  of 
training  schools,  called  upon  Dr.  I'r.ineis  Ha.  on,  ac- 
comjjanied  by  his  and  our  friend  Dr.  Wi'liam  b. 
Mradlev,  for  the  ]iuri)osc  of  coasulting  him  as  to  the 
desirableness  (jf  attempting  to  e.-;tablish  a  school  tor 
nurses  in  Xew  Haven. 

So  that  b-om  two  different  directions  simnlt.aneou^ly 
a  movement  was  being  made  which  resulted  iii  the 
founding  of  this  school. 

Mr.  Thonn)S(m's  interest  was  gratefully  appreciated, 
and  the  result  of  his  conversation  with  \h-<.  ibadley 
and  H.ieon  was  that  he  was  asked  to  draw  u]i  a  j^lan 

I  Si'c  The  Scmi-(\'iitiiiniiil  History  oj  the  (ifiwral  Ilospilal 
Soiiciy  of  Couiiiitinit.  hv  P  .\  Jcwctt  MD  N'ew  Havii,. 
1876. 

■  Kfatl  at  the  ,t,'r.i(luatinK  ixerci.ses.  1845  Reprinted  i:i  /  iif 
Traiiiid  .Viirsi-,  Oelohor,  i.Soi,  pp.  187    193. 


A  Trio  of  Training:  Schools 


4^5 


ciubudyinp;  his  ideas  as  to  tiie  trainint^  of  mirses, 
and  this  plan  was  submitted  to  tlie  committee  above 
mentioned;  and  iDllowini::  this,  at  the  next  meeting; 
of  the  (leneral  Hospital  Society,  this  paper  was  read, 
which  Dr.  Bishf)p  has  kindly  copied  from  the  jjrocecd- 
in,i,'s  of  the  society,  Ajiril  17.  1873: 

"The  committi'e  to  whom  was  referred  the  subject 
of  a  training;  school  for  nurses  would  respectfully 
report ; 

"ist.  That  in  their  opinion  it  is  not  expeiiient  for 
the  Hospital  Society  to  undertake  the  direct  or<,'anisa- 
tion  and  n!ana,t,'ement  of  a  trainiiiL,-  school  for  mn-ses. 

"2nd.  The\'  are  hi.irhly  gratified  to  learn  that  ar- 
ran<,^(>mcnts  are  in  pmirrcss  for  the  orjj;anisation  of  a 
training  school  tor  nurses  b\'  a  societ\'  devoted  to 
that  special  ol>j(\-t.  They,  therefore,  recommend  the 
adojition  of  the  following  rcsfilutions: 

"  l\csi)/ii\!.  That  this  society  feels  deeply  im- 
]ircssed  wiih  the  importance  of  encouraging  in  e\-cry 
'Suitable  m.anner  the  spcci.al  education  and  traitiing  of 
nurses  for  ser\  ice  in  hospitals  and  in  pri\-ate  families, 
and  for  at  tendance  upon  the  sick  ])oor;  therefore, 

"  Rcsi^h'cJ.  That  if  a  society  is  organised  for  the 
ti'ainini:  of  nurses,  the  directors  of  the  General  Hos- 
pital Soriet\-  of  Connecticut  are  hereby  authorised 
and  ad\ised,  mnUr  suitable  regulations,  to  atYord  to 
said  society  such  facilities  for  the  instruction  of  nurses 
as  can  be  giMii  at  the  hosjiital,  consistent  with  the 
proper  management  of  and  genera!  interests  of  the 
hospital. 


"  (Signed). 


M    C.  Wmitf,      ) 

I).  L.  D.vor.KTT,  -  Coiiuiiiltce. 

V.  A.  Jewett,     ) 


426 


A  History  of  Nursinc: 


It  was  a  very  fortunate  coincidence  thai  just  at  tlie 
moment  when  the  Ilosjiital  Society,  after  a  year's  con- 
sideration, li.-.d  decided  a-ainst  ori,'anisin,u'  or  nian.a.L,'- 
in^:  a  training  school,  we,  without  collusion,  sliould 
have  offered  to  do  this  work  for  tlie  institution. 

This  report  of  the  hospi'al  (  ommittee  to  the  IIos- 
])ital  Societv  is  the  first  dcimile  and  orticial  action 
taken  u;on  tlie  suhject  of  training  nurses  in  Xev,-  Ha- 
ven. It  is  the  Utile  seed  from  which  we  have  in 
twenty-one  vears  branched  out  into  full  usefulness. 

Acting  u|.on  tlio  encourageini'nl  thus  recei\cd,  and 
inspired  hv  Mr.  Thompson,  thirty  or  forty  ladies  and 
gentlemen  associated  themselves  for  the  organisation 
of  the  Connecticut  Training  School.  A  pamiihlet 
e.Kl'laining  tlie  plan  ami  setting  forth  its  ad.\-antages 
was  in-inted  at  Mr.  Thompson's  expense,  and  tlie  co- 
operation of  all  good  citizens  was  asked,  packages  of 
the  pamphlets  and  circulars  were  mailed  to  every 
j)roininent  ;  hysician  and  clergyman  in  tiic  State,  and. 
many  cordial  endorsements  were  received. 

After  a  careful  ^tudy  of  the  English  hospital 
school  mclliods.  a  pl.m  was  drawn  up  for  the  organ- 
isation of  this  school  and  for  its  connection  with  tlie 
hospital,  -series  of  resolutions  were  iwopost'd  tor  the 
c( msideration  of  the dircct( >rs f )f  the  hosj ntal ,  and,  armed 
with  all  this,  Dr.  Bacon  presented  to  the  directors  at 
their  next  nu-i'ting  the  i^roposa!  that  t!ie  new  org.anisa- 
tion  should  assume  the  ciiarge  of  the  nursuig  at  this 
iiospital.    .   .   . 

These  resolutions  are  the  ones  which,  printed  and 
framed,  hung  for  years  in  tiie  hospital  ollice.  and  they 
give  our  status  with  regard  to  the  hospital,  detme  our 
relations  with  each  other,  ami  they  have  been  exten- 
sively borrowed  by  other  training  schools. 


A  Trio  of  Training  Schools        4-7 


Here  we  were  then,  fairly  launched,  but  without  a 
])ennv  of  nioncv  "r  a  single  pujiil,  and  now  the  hard 
work,  whicli  ff)r  tweny-one  years  the  school  commit- 
tee has  carried  on,  commenced.  The  ladies  at  once 
set  themselves  to  the  work  of  findini;  pupils  and  secur- 
inir  a  su[>erintend('nt.  Circulars  in  kirLje  type  and 
briifnt  colom^s  were  distriliuted  at  the  ra'ruad  stations 
and  mailed  t'l  rural  o.  ist-<.!'lic<'S,  with  the  request  that 
the  pcjstmaster  wouid  pin  them  up  in  some  conspic- 
uous ])lacc. 

Ladies'  missionaiv  associations  in  eighteen  towns 
were  asked  to  niakt  the  i>!an  known  and  to  put  up,  in 
places  where  they  •.ould  attract  attention,  the  adver- 
tising circulars.  Articles  were  written  to  all  the  lead- 
ini^  new'^j/ajjcrs  of  the  State,  and  were  t'\tensi\'ely 
cojiied  in  the  smaller  rural  joiu-nals.  Xearh  all  the 
applicatiiins  came  fruni  younLT  ^\'onlen  who  lia<l  read 
in  obscure  \-ilIa,<,'es  the  articles  ccj^iied  from  jjai-ers  in 
larger  towns. 

While  all  efforts  were  beinij;  made  to  interest  yountj 
\\'<imen  and  secure  pupils,  Mr.  Thompson  de\'oted 
himself  to  raisin.Lr  muiu'y,  and  Init  for  his  .t^'cnerosity 
we  could  nut  have  be.t^um  the  school.      In  Scjitember, 

1573.  he  authorised  us  to  draw  upon  him  fi  r  Si.ooo, 
and  under  certain  conditions  for  Sj.;oo.      In   March, 

1574,  throuji;!!  the  kindness  of  Ih'.  Moses  C.  White, 
Mrs.  (iji;.  i.f  \\'c'-t  HaMMi,  left  us  a  tract  of  land 
which  will  later  become  valuable,  ;ind  through  Mr. 
Thompson's  i"urthcr  etTorts  Sio,ooo  to  Si  2.000  were 
contributed  by  many  generous  friends  as  an 
endi'wmcnt. 

May  21.  1873,  the  full  school  commit!  ".  held  its 
first  formal  meeting  for  the  appointment  of  a  superin- 
tendent of  nursing.     Many  hospitals  had  been  visited 


428 


A  1 1  i story  of  Xursingf 


and   inquiries   made,   and    at   last    the   only   trainin.t,' 
sehool  in    cxistcnec  in    tliis   eountry   [this    statement 
overlooks  the  Xew  l-,iiL;laiid  hospital  for   Women   and 
Chiliir(n],    tiie    Woman's    husjiital    of      Philadelphia, 
referred   to  above,   sent    us  nur   first  superintendent. 
AnsAvers  bccfan  to  come  in  tri>m  applicants  for  admis- 
sion, and  out  <'\  t\venty-o!ie,  six,  the  numl)cr  to  which 
the  hospital  limited  us  at  first,  were  finally  selected. 
Tv.-o  of  tliese  failed,  I'lmu.i,']!  sickness,  at  tlie  last  mo- 
ment, and  on  Octol)er  (>,    iSys.  our  first   f"ur  jiupils 
arrived  late  in  llie  e\'eninL(,  and   in  a  dreary  storm. 
Tlic  new  wards  to  tlie  st)uth  were  n'>t  free  from  the 
workmen,  but  small  slecjiin^t,^  rooms  were  assii^MKnl  to  us 
on    the    t"p   floor,    and    comfortably    furnislied.      The 
diet    kitcluii,  in   tlie  basement,  liad  been  fitted   Uji   at 
the  expense  of  tlie  trainiiiL,'  sclimil.   fluor  laid,   stove 
and   kitchen   utensils  supplied,    and   our   four   nurses 
and    tiieir    superintendent  found    themselves  at    once 
jjiuiiLrcd  intn  hard  work.      Tlie  north  ward  was  full  of 
tyjilnud  fe\er,  ten  cases,  six  men  and  four  women,  ami 
wards  1  and  2,  K  ami  \V.,  were  opened  and  tilled  dur- 
in.i,^  the  first  wruk.     The  committee's  journal  reads: 
"( )ur  nurses  for  tlu'  first  five  weeks  ilid  ver_\-har(l  work. 
The  fever  cases  were  severe,  some  ol'  the  patients  ea- 
tirely  delirious,  throwinj:^  themselves  out   of  bed,  or 
ji;ettinif  up  and  dra,i:,i,nn,t,'  their  sheets  and  blankets  out 
into  the  entry,  if  the  nurses  had  to  cross  from  the 
men's  to  the  women's  ward.     The  four  nurses  in  turn 
sat  up  nijjht  after  ni.t^ht  and  did  duty  durin.i,'  the  day 
in  the  other  wards,  or  diet  kitchen,  where  the  sijecial 
diet  for  thirtv  was  cooked  and  distribulcil  to  all  i»arts 
of  tlie  hospital  by  the  nurses  uho  ayokcJ  :!."     Th.e  j-  >ur- 
nal  adds:  "All  the  men  nurses,  on  the  arrival  ^f  the 
young  women,  at  once  s^et  themselves  to  take  their 


A  Tri<)  of  Train ini:  Schools 


429 


ease  and  Im  shirk  all  fonceru  wilii  ilistrihiilin.i;  the 
diet  or  returning,'  the  dishes." 

The  school  ;)t  last  en,',';i',_Td  aiid  paid  three  woinen 
from  the  eit\-  to  lieli)  in  the  stress  of  work.  On  the 
ist  of  Oetober,  187;,,  there  were  seventy-two  ])atients 
in  the  hosjiital,  but  by  December  31  the  average  for 
the  rjuaiier  liad  risen  to  110.  Xoi  until  a  xcar  later 
had  we  ])ernussion  to  raise  the  numl;er  of  tjupils  to 
ei,<,dit,  and  it  was  Muy.  1875,  before  we  were  allowed 
nine  in  consequence  of  I  he  ni<,dit  service. 

Hard  as  the  work  lias  often  been  in  later  \-ears,  no 
class  of  nunscs  ever  had  such  demands  made  u[)on  its 
endurance  as  this  pioneer  class  of  pupils  met  and  struj,'- 
yled  through.  All  the  typh(jid  fever  cases  recovered. 
and  it  was  a  jjroud  inoinent  for  the  school  wlien 
the  value  of  the  work  done  was  full\-  appreciated  and 
acknfnvled.^'cd  by  Dr.  Moses  C.  W'hi'.e,  the  attending,' 
{jhysician.  "I  ha\-c  never  before,"  he  said,  "had  a 
case  of  fc\er  in  the  hosjital  without  a  lilack  crust 
tonpjue,"  no  ap])earance  of  whic-h  had  he  found  since 
our  nurses  took  hold.  ThrouL;h  Dr.  White's  efforts 
little  improvements  were  added,  and  at  the  request  of 
our  superintendent  lie  .secured  additional  closets  in 
the  north  ward  entries.  Our  nurses,  who  have  more 
closets  than  they  know  what  to  d(;  with,  mav  think 
what  such  a  statement  as  this  in  the  committee's 
journ;il  implied  "The  new  closets  bein,^;  put  up,  the 
miscellaneous  packin.2[  of  slices  oi  breail,  old  clothes, 
bedflin.i;,  f)il  lamps,  ra^'s,  etc.  (which  had  always  been 
stowed  in  the  same  closet)  was  put  an  end  to."  I 
mention  these  iittle  details  that  our  nurses  v^w  more 
fully  ajipreciate  the  comfort  which  has  surrounded 
them,  in  contrast  to  the  ditlieulties  faced  by  the  hrst 
bra\'e  four.      Everything,  us  I   have  said,  was  in  a 


430 


A  History  of  Nursing 


i 


transition  slate.  Tlic  nurses  \vf'r(-  rr'iwilrd,  as  lli(Mr 
numbers  increasc<l,  into  the  tlnn^e  small  rMcms  in 
tlie  top  Hour  of  1  he  ni-\v  liuildinj^-four  in  a  room  aii'l 
the  clothes-horse  screens  -vhich  diviiled  their  beds  one- 
from  another  were  the  first  screens  of  ilic  kind  used 
in  the  hospital. 

The  tirst  suijerinlendent  of  nursin.fj  was  asked  to 
take  her  dinner  at  the  table  with  fourteen  men  ])a- 
tients  in  the  basement,  and  later  the  pupils"  meals 
were  served  in  tlieir  own  diet  kitchen,  and  VL-vy  poor 
ones  lhe\'  were,  too.    .   .   . 

The  ladies' >  Minmittee,  too,  was  new  to  the  business 
before  it  and  learned  by  experience  the  needs  of  the 
school.  f)nc  of  the  tirst  tliin,u;s  to  do  was  i"  abate  the 
trailin.L;  skirts  and  jewel-i'v  of  the  iiewl\-  arrive''.  pui>ils, 
whose  ideas  were  crudi^  as  to  th.e  proper  dress  for  a 
trained  nurse.  I  remem])er  one  niornin,^  I  was  met 
by    tlie    liead  nurse    witli    the    desjiairinL:    cpiestion: 

"What  skill!  I  du  witii   ^^ss ?     Slie  appeared 

at  breakfast  wit li  all  her  Iou.l:  hair  t'urled  down  her 
back."  Ca!)S  were  inunediately  introduced,  and  no 
one  needs  now  to  be  told  tiiat  bush_\' hair  is  out  uf 
lilacj:  in  a  sick-ronm.  All  the  irre,<,ailarities  were 
slowly  corrected;  comfort  came  out  of  confusion. 
The  suri;eons,  assured  of  ^ood  nursin,i^\  umlertook 
operations  never  before  attempted  in  a  hospital. 
And  I'U  .March  26,  si.\  montiis  after  we  be.s^an,  the 
Hospital  vSociety,  which  had  (jrdered  an  inquiry  made 
as  to  our  work,  directed  the  secretary.  Dr.  C.  A.  Lind.s- 
ley,  to  inform  us  in  uritin,:.,'  as  tolidws:  "In  retjanl 
to  the  work  undei-takcn  by  rl;e  school  in  the  care  of 
the  sick  and  disabled,  we  find  for  iv  many  .c;eneral 
commendations.  The  physicians  and  surireons  report 
a  decided   improvement   in   the   nurs;n,i;,   and   speak 


A  Trio  of  Traininiji"  Schools        431 


str()nj,'ly  of  the  j^ooil  already  accomplished."     By  the 
end  c)f  the  first  year  nearly  one  hundred  aj)plications 

for  admission  to  the  school  liad  been  made,  and  we 
had  all  the  pupils  wc  were  allowed  tn  ret'ei\-e,  th(jut,'h 
a  majority  of  the  younL,'  women  withdrew  their  names 
on  learnin.u;  that  hard  woi  k  was  required.  For  it 
came  to  he  slowly  understood  1)\-  outsiders  that  luvrt 
and  soul  and  mind  and  streni^'th  must  !>e  put  into 
this  work  if  it  were  to  be  well  done.  There  was  the 
same  lack  ot  luiderstan  h'lpi,'  diu'iipL;  our  Ci\-il  War.  and 
anionj.;  the  inthusiasts  who  wished  to  be  forwarded  to 
the  front  came  a  younj,;  Xew  \'ork  woman  to  the  nurs- 
in.Lj  committee  otie  ila\",  ai^d  stated  iier  rei|uirements 
in  taking;  up  the  ser\'iee  for  the  womid(d.  They  in- 
eluded  a  daily  iiath  on  i,ie  battle-field,  and  wh.en  eom- 
mi;n-sense  was  talked  to  Iter,  an<l  her  ser\iees  were 
declined,  she  lel't  ^'really  disturbed,  and  savin<,'  that, 
thou.t;!!  she  could  not  work,  she  thoui,dU  she  might  be 
allowed  to  soothe  and  s\'m])athise. 

Hy  the  end  of  our  second  _\  ear  we  were  al>le  to  send 
out  our  hrst  .graduates  to  prix'ate  fatnilies.  Si.x  of 
them  nursed  thirty-se\'en  cases  with  entire  satisfac- 
tion to  the  patients.  By  the  fourth  year  we  be,L:an  to 
furnish  su])erintendents  of  nursin,s.j  to  other  hospitals, 
and  to  nurse  the  ;)oor  tree  of  charf,re  in  Xew  Haven. 
Fifty  charity  visits  were  made  that  year.  Bv  the 
si.\th  yi'ar  we  felt  stroni,'  cnouij,di  to  publish  our  own 
hambbook  of  nursin.i;.  By  the  seventh  the  se\'en- 
teen  ]>upils  had  quite  outLjrown  their  rpiarters  in  the 
mansard  story,  and  .Mrs.  Xoah  Porter,  the  president 
of  our  board,  appealed  at  our  amuial  meeting,'.  Janu- 
ary, 1 88 1,  for  funds  to  build  a  dormitorv.  So  com- 
plete was  the  public  confidence  in  us  that  the  entire 
amount  (Si.;,ooo)  needed  for  the  building  was  raised 


432 


A  History  of  Xursin<j^ 


at  once,  and  Professor  Eaton  and  Dr.  Bacon,  wlio  had 
been  appointed  by  the  hos]iifil  dirt'ct'TS  tor  tliis  ser- 
vice, staked  out  the  site  on  tlie  iiosjiital  l^'ro^^!ds,  and 
1j\-  ( )(t"!K'r  2i>.  18S2.  onr  1  leasant  buildinu;  was  opened, 
^h•.  K.  S  I'edow  and  Dr.  Shew,  of  tlie  Middletown 
hospital,  havin.i,'  selecteil  for  ns  the  furnitnre  from  a 
faetorv  in  Xev  Hampshire  at  a  cost  ot  about  Si. 000 
more.  We  were  in  ( li.ar  water  now,  and  httie  renuuns 
to  tell  vou  except  a  story 'jfcontiinial  prosperity.   .   .   . 

In  concUidin'j:  this  sketch  of  tlie  early  il.i\-s  of 
np.r  first  thri-'  --hools  for  mirses  Ave  canimt  d-i  bet- 
ter lluni  iitiote  from  a  j  aniplilet  written  b\- one 
of  the  In'llevue  llos])i!.al  coininittee'  wliieh  is  full 
of  practic.il  W'sdoni  and  foi-esi,;iit.  After  ;i  bi'o  id 
historical  '"e\arw  ;mil  st;id\'  of  iiuthods  ot  institti- 
tioiial  niana^HMTiont  it  ])oints  out  the  aiiachronisiit 
of  haviiii;  the  goveniuv^  boards  f^r  iin.xed  institti- 
t'ons  composed  entirely  of  juen,  and  says: 

The  most  thoroujih  way  to  secure  oneness  of  orj^an- 
isation  and  purjiosc  would  be  to  add  to  the  hosjiital 
board  a  certain  nuiniier  of  Indies,  and  to  make  the 
school  of  nursinj,'  eonunittec  one  of  the  regular  sub- 
committees of  the  board.  .  .  .  Hitherto  the  move- 
ment toward  improving  the  nursing  service  of  public 
hospitals  has  come  from  outside  persons  as  a  rule:  it 
has  not  originated  with  the  governing  bodies.  As 
nursing  is  work  which  jjeculiarly  requires  feminine 
supervision,  the  majority  of  the  members  of  school 
committees  hitherto  ha\e  been  women.  ...  If  hos- 
pital governors  object  to  extraneous  authority  .... 

'  A  ('rntnry  rf  Xitrsin^,  with  Hints  ton-ard  the  Ori^antsatioit 
of  a  Trainin(>  School.     (The  author  was  Mrs.  Hubson.)     1876. 


A  Trio  of  Trainini^  Schools 


4oj 


why  shcmlil  they  not  invite  the  school  committee  to 
become  members  of  their  board  ....  under  their 
own  control  as  are  their  other  committees'   .    .   . 

In  the  case  of  a  lar<,'e  public  hospital,  /.  c,  a  tax- 
payers' hospital,  the  outside  committee  has  its  advan- 
tatjes.  If  its  members  find  themselves  unreasonaVjly 
Mh-;triKted,  tliey  hax'c  the  remedy  of  the  English 
ministry:  they  can  "go  to  the  country." 

A  j::;reat  deal  would  depend  upon  the  character  of  the 
hospital  and  its  own  form  of  .government.  Any  plan 
of  organisation  is  the  best  which  will  keep  all  discus- 
sion of  questions  of  general  policy  and  of  the  mutual 
relations  Ihat  are  involved  aboveboard  and  open, 
and  thai  will  leave  neither  opportunity  nor  necessity 
for  attemjit  on  the  i)art  of  anyone  to  carry  points 
by  indirect  or  personal  influence.  .  .  .  Better  the 
treaties  which  the  Paris  administration  makes  with  its 
Sisterhoods  than  any  effort  to  diplomatise  one's  wav 
into  a  hospital  and  shuffle  along  there  without  a  full, 
clear,  written  agreement  on  the  points  in  advance,  so 
far  as  they  can  be  foreseen,  between  the  committee  of 
the  school  and  the  governing  bodies  of  the  hospital.  .  . 

As  the  object  of  the  hospital  is  the  nursing  of  the 
sick,  the  sujierintendent  of  the  school  becomes  the 
most  important  female  officer.  She  should,  therefore, 
if  possible,  be  the  matn.;!  as  well  as  the  nursing  head 
for  the  whole  hf)spital ;  in  which  case  she  would  require 
an  assistant  to  whom  she  could  delegate  certain  classes 
of  housekeeping  duties.   .   .   . 

Too  frequent  changes  among  head  nurses  are  unde- 

irable  from  a  discij>linary  point  of  view.     It  wouhl 

lie  an  advantage  to  a  school  to  he  able  to  retain  and 

pay  adequately  a  certain  number  of  skilled  trainers 

for  head  nurses  of  wards  or  groups  «jf  wards.  .  .  . 


434  A  History  of  Nursing 


Cnmmittoos  would  do  well  to  start  on  the  plan  with 
the  idea  thai  careful  dicku'tio  and  teihnieal  instruc- 
tion must  le  a  jiart  of  their  plan  and  that  the\-  will 
ni  I'd  a  school  outfit:  classroom,  blackboard,  text^ 
Iniok.  and  manikins'  the  cost  of  which  should  he  con- 
sidered an  ("^st'ntiai  ori.L,nnaI  liutlay,  and  not  left  to 
any  after  chance. 

American  schools  pay  their  pu]nls  monthlv  wa.t^es, 
but  these,  if  paid  at  all,  ouphl  to  be  moderate.  Schools 
sh'iuld  not  CMnii)ete  with  each  other  on  the  basis  of 
numbers  or  hi.u^h  waj,'es,  Init  <>n  that  of  the  qualitv  of 
nurses  they  turn  out,  and  the  best  pupils  are  sure  to 
\alue  instruction  more  if  they  are  not  fiaid  for  acquir- 
in.i:  it.  Those  schools  will  probablv  iiro\e  lo  be  the 
most  successful  where  the  pupils  can  be  brou<,dit  to 
feel  that  they  are  studying;  a  jirofession,  or  learning'  a 
trade,  under  the  ordinary  conditions  imposed  on  men 
and  Women  wh.o  are  jireparinj^'  themselves  for  any 
business  in  life. 

It  is  a  (jucption  whether  a  nursinp  school  should 
class  itself  with  charities.  If  nionev  appeals  to  the 
public  must  be  made,  why  should  they  iiMt  be  made 
on  the  Iiigher  j^'round  that  colleges  take? 

Why  should  there  not  be  endowed  tutorshij'S 
and  free  scholarships  for  nurses  in  Bellevuc  and 
H.dtiiiioTe?   .    ,    . 

In  concludinj,'  this  brief  sketch  the  writer  urjjcs  all 
women  engaged  in  hospitals  and  training  schools  to 
bear  in  mind  that  their  greatest  success  will  lie  in 
keeping  the  standard  of  their  work,  as  to  the  char- 
acter and  tone  of  the  direction,  and  the  quality  of  the 
instruction  given,  at  its  highest  possible  point.  S<  Itools 
should  be  practiially  normal  schools,  whose  graduates 
should  feel  that  wherever  they  go  they  must  carry  the 


A  Trio  of  Training  Schools        435 

spirit  of  the  schnol  witi  tlicni  ami  tliat  trainin.i:;  can  ^o 
nn  in  e\cry  huspita!  ward  where  a  competent  heaii 
nurse  is  found. 

HoviPtle-^  then  will  Ijc  olistacles  to  encounter. 
but  these  should  onl_\-  ner-.e  to  stt\adier  efTort,  for  it  is 
well  to  remember  that  any  obstacle  either  thou.i^dit- 
iessly  or  malic-iously  thrust  in  the  way  of  women  (;f 
culture  whi  i  undertake  otlices  of  idiaritv  in  public  insti- 
tutions is  a  blow  direct,  not  so  much  atjainst  thcni,  as 
aisiinst  the  helpless  and  sufferin<j  classes  of  society 
uf  whom  they  are  the  natural  guardians  and  consolers. 


,£>€2imi. 


/i^.  4CX001; 


h 


BIBLIOGRAPIIV. 

Tlio  croiipiriH  .-icionlinB  to  subject  is  to  facil.tatc  stmly  or  i  curses  of 
nviiliiK.  Some  of  the  footnote  refcriTii  us  arc  ri'iieated  here,  while  utiier.^ 
are  new.  No  attempt  has  been  made  to  wive  a  full  list  of  niaKaz  ne  artiiles. 
Many  books  on  nursing,  as  well  as  text-lxx)ks,  lrelort;inn  mure  espe'ially  to 
ihe  last  twenty-five  years,  will  be  listed  in  another  volume. 


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437 


43^ 


A  History  of  Nursing 


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439 


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mission of  his  family,  by  Catherine  W'inkworth.  London,  1S67. 

*  Das  Diakonisscn  Muttcrhaus  iimi  seine  Tochtorliduscr. 
Dr.  Julius  Uisselho  '',  Kaiserswvrth.      180^. 

*  Kaiscrswcrth.  Zur  I-yiiuiruii:^  an  den  Bcsiich  dcr  I 'ia- 
konisscn  Anstalt  in  Kaiscrsiiecrtli. 

*  Jubilate.  Penksclirijt  ziir  Jubeljeiir.  Julius  I )is.=;e!hotT, 
Kai.serswerth,  18S6. 

*  Jalirbiich  fur  C'hristliehe  l'iiter!i(iltu)i\;.  Kaiserswerth, 
[.Sv4.      Lives  of  Friederiko  and  Caroline  P'liedner. 

*  Theodor  Fliediier.  Kur:er  Abriss  seines  I.ebens  und 
Wirkens.  Georsi;  Fliedner.      KaisorsutTth,  i.S86-(;2. 

Theodor  Fliedner,  der  Begriinder  von  Kaiserswerth.  I'ritz 
Fliedner,  1SS6. 

Gertrud  Keieltart .      .\rn<.,u  uv.d  ',\rarJ:eit  ]''reiiiid.  iS''ii). 

Kolb  ktenreise  naeli  litdUind  uiui  Kni;land.  Tli.  i'liedner. 
Ivsscii,  HadekiT,   i  S  ;  i . 

I  las  l-'rsti  l,iiir-/elnil  der  I  >i<iko)ussr)i  Aiistalt.  Kaisers- 
werth, i8,^()-,^7. 

I\nr~e  Entste!ilini;ss;<sehielite  der  ers.i'n  t'ear^^el.  I.iebesan- 
stalt  :ii  Kaiscrsurrtli.  Arinen  und  Krank-iii  l''reund,  1S56; 
also  sefiarate  leaflet. 

l[uus-<  hdnunj^  und  I  )ienstamvcisu  n  i;in  jar  die  Diakonissen 
Anstalt  :ii  l\'aiscrsu'erth.     Th.  I'liediier.      K.iiserswcrth,  1845. 

*  /.;/(•  (1/  .-{ fines  Elizabeth  Jones,  by  her  sister.  (Contains 
much  detail  of  the  life  at  Kaiserswerth,  where  she  spent  a 
year.  Aiipendi.K  A  was  first  publisheii  in  the  Dublin  I'ni- 
ver\itv  Mat;a:ine,  April,  1851),  as  an  article  called  "Kaisers- 
werth, tlir  Tr.iitiiniT  School  of  Florence  .\ii,'htinpale." 

*  .1  I'ili;riniai;e  to  Kaiscrs-.eerth.  L.  L.  Dock  in  ^hort 
Studies  on  Xursing  Subjects.     New  York,  lyoo. 

NIGIITINCi.M.K    HIHI.IOC.R.VHIIV. 


Experience  oj  a  Civilian   in    Eastern    Military   Hospitals. 
Peter  rincolTs.  M  D.      Williams  iV  N'org.ite,  London,  1857. 


440 


A  History  of  Nursin^^ 


Excellent  aceount  of  Miss  Xii;!- Iii^'mIi'  in  the  ehapter  lalK-il 
"The  Providence  ut  the  Barrack  llospit.il. 

Day  &• 

A  L'cjcul 


The  Scat  of  War  in  the   East.     William   Siiniisnn. 


Sons,  Liinilfin,   i(,02.      i-ieprintcil  from   ed.  of    1.S55. 
ehajitiT  on  Mis^;  Xi^'htin,i:;alc. 

The  lUnstraled  History  oj  the  \\\ir  :eith  Russia.  E.  H. 
Xolan,  Ph.D..  I.L.D.  J.  S.  Virtue,  London,  1857.  Excellent 
aceount  of  Miss  .Xightingale  in  chapter  called  "Scutari  and  its 
Hospitals." 

The  Invasion  of  the  Crimea.  Kinglake.  iS.So.  \'(i\.  6, 
eh  ip.  xi.  An  c  \i  elKiit  and  fascinating  (.hapter  on  .Mi,-;s  .X. 
and  her  work  c.illed  "  The  Care  of  the  Sick  and  the  Woundeii." 

*  Scutari  and  its  Hospitals.  Rev.  Sydney  G.  Osborne. 
Dickenson  Bros.,  London.  1855. 

The  Story  oj  Florence  \ii;hti}ii^ale.  W.J.  Wintle.  .'<uuJav- 
School  Union,  London.  .Xo  date,  dood  anil  detailed  account 
of  her  early  life. 

*  Fhreme  .\i^i;htie.oale.  I-:iiza  F .  Pollani.  S.  W.  i'artridgc 
Co.,  Lomlon,  ii;cj.  The  most  com;dete  and  full  as  to 
detail,  (juiet  and  authoritative  in  tone. 

Fii^hts  /'or  the  Flai:.  ('ontains  life  of  Miss  .XiL,'htingalc 
called  "The  Lady  with  the  Lamp."  W.  H.  I'llchelt.  ("■<■". 
Bell  iV  Sons,  Lonrlon,  iSgS. 

*  Great  .^[en  luui  Famous  Woineu.  \'ol.  iii.  Life  of 
.Miss  .Xightingale,  by  Lizzie  Aldridge.  Selinar  Hess,  Xew 
V..rk. 

*  .Xotable  \\'(i)iu-)!.  Contains  life  of  Miss  Xigiitingale. 
Ellen  C.  Clayton.      Dean  tS:  Son,  London.      .Xo  date. 

*  The  Life  of  Florence  .\'ii;htingale.  Sar.  h  Tooky.  Hous- 
field  ('c,  London,  i(/o6. 

*  Ltje  of  Sidney  Herbert.  Lord  Herbert  of  Lea.  By  Lord 
Stanmore.  Murr.iy,  London,  mo;.  In  2  vols.  Cont.iins 
portions  of  Miss  .Xightmgale's  letters  not  heretofore 
publishciL 

MISS  \igtiti\o.\i,k's  writixcs. 

1851.  The  J'rotestant  Deaconesses  of  Kaiscrs-arrth.  A 
'pamphlet  describing  the  Kaiserswerth  institutions  and  train- 
ing. A  long  quotation  from  it  in  Appendix,  Xote  A,  Hos- 
pitals and  Sisterhoods,  by  Miss  Stanley. 


BiblioL^raphy 


441 


I■'^^7.  Stalcinruls  Exltihitini^  the  Voluntary  (\nitribiitions. 
Hrini;  a  rcjiort  Kiving  compkte  statistics  and  record  <if  all  the 
V. .lutitary-  contributions  which  had  passed  throu,i,'h  her  hands 
during'  the  war.      Harrison,  St.  Martin's  Lane 

iS"-i86o.  .1)1  F-xhaitsiivr  and  Confuiciituil  Report  nn  the 
Workingsoj  the  Army  Medieal  I  )e  partnient  in  the  Crimea.  Lsi  d 
in  the  reorganisation  of  that  service.     N'ever  printed. 

*  1.S58.  Xote^  on  Matter!;  Ajjeetiii!;  the  Health,  KlJicieney, 
and  Hospital  A<lnii)ii<tratio)t  oj the  British  Army. 

*  iS^().  Xotes  on  Hospitals.  First  presented  to  the  En<;l. 
Xat.   Asso.  for  the  promotion  of  Social  Science. 

iSv).       r"iilarL;c<l    and    n'\i.-;i-d    editii.m    of    same.      Loiij,'- 
mans,  tircen  >!v;  Co. 

*  i860.  Xotes  on  Xursint;;  W'luit  it  Is  an!  What  it  h 
Xot.     In  many  editions.     D.  Appleton,  Xew  York. 

*  1S61.  Xotes  on  Xitrsini;  for  the  uabourii:^  Classes.  A 
niodifud  edition  of  Xotes  on  .Xursiiii;,  with  special  reference 
to  the  care  of  babies,  and  a  new  chajiter  aildressed  to  the 
older  sisters  (little  mothers). 

1862.  Army  Sanitary  Administration  and  its  Reform  under 
the  late  Lord  Herbert.  Read  at  London  meeting  of  the  ("ori- 
grcs  de  Bienfaisance,  June,  1862. 

1863.  'I he  Sanitary  .S/a/c  of  the  Army  in  India.  Observa- 
tions on  the  e\idence  contained  in  the  st.itistical  rejjorts 
submittt'cl  to  her  by  the  R'  lyal  Commission  on  the  same.  Re- 
printed by  <jrder  fnjin  tlie  report  of  the  Royal  Commission. 
Edw.  Stanford,  6  Ch.iring  Cross,  1S63. 

i.S');.  Hole  People  may  I.ive  and  not  Die  in  In,Iia.  Re;id 
at  the  Edinburgh  meeting  of  the  Xat.  Soc.  Sci.  Cong.,  in  1865. 
Reprint  as  p.imjihlet. 

*  1S65.  ,4);  I  ntroduction  loan  ■{ecoti):t  of  the  ( 'rit^in  and 
Ort^anisation  of  the  Liverpool  Sehool  and  Home  for  Xiirses. 

*  1H67.  Suggestions  for  the  Improvement  of  the  Xursing 
Service  of  Hospitals  and  on  the  Methods  of  Training  Xurs-s 
for  the  Sick  Poor.  Written  liy  request  of  the  Poor  Law 
Board  after  the  Poor  Act  of  1867;  in  their  reports  and  in 
Blue  Booh,  "Metropolit.in  Workhouses." 

*  1868.  Una  and  the  Lion.  An  introduction  to  the 
Memorial  of  Agnes  E.  Jcmes,  by  her  sister.  First  appeared 
in  Good  Words,  June,  1HO8. 


442  A  History  of  Nursing 


*  1S71.  T.yiin^-in  llo^pitah:  u-itli  a  Proposal  for  Orpau- 
i.^inil  ail  hwtiHiU-  /or  J'raiiiiiii^  Midifivcs  mid  .^i  iilwifcry 
Xltrsrs.      Li)n.L,'tTians,  (jiTi'ii  Ov;  Co.,  1S71. 

1873.  Li/'c  or  Death  in  India.  Kr.id  at  the  Norwich  meet- 
ing of  the  Xat.  Assn.  for  the  rnmii.tiiai  of  Soe.  Si  i.,  1S7,:;. 
Pu^ihshed  as  pamphlet  with  an  ai)]'etiih.\  cui  irriijation,  ealUd 
"  Life  or  Death  liv  Irrij,'ation." 

*  1S73.  ".-1  Suh-Xott-  of  Ii:!t  rroi:ation  "  Frascr's  .1/(it;u- 
ziiio.  May,  1S73. 

T.S76.  A  letter  ti)  the  Tnircs,  Ajiril  14.  Rejirinted  as  ]iaTn- 
jihlet  calleil  Trained  A';rr,w;;;;  for  the  Sick  I'oor:  a  Iloin,-  ;or 
A'Kr.sc.T  in  ronncction  loitl:  tho  Xatioiial  Society  for  I'rtreidin^ 
Traiced  Xi'.rsing  for  the  Si,k  I'oor.  Kxjiresscs  her  views  on 
district  nursini;. 

iS()i.  Article  on  IIospi;ats  and  ^  iiniiii.;,  C'liaiubers'i  I:i.- 
cyclopcdia. 

*  iSi)2.  The  Reform  of  Sick-Xtirsiui;,  and  the  Late  .l/r,v. 
Wardroper,  Brit.  Mcii.  Journal.  Dec.  31. 

*  iS'lj.  Knral  Iiyi:icne:  Ileal:!:  'Tcachinils  in  To:eH.s  and 
I'illat^es.  Read  at  the  ('Mnference  ui  W'nmvn  WcrkiTs, 
Leeds,  XoveinluT,  iSi;;;. 

*  i.So^.  Sick-Xiir.suii;  and  Ileallh-Xursini:;.  Written  fur 
and  read  at  the  Xursiili,'  Section  of  the  (~on.L;n'SS  of  ('liaritii.s 
and  C'jrrectmn  in  ('hicaL;o,   World's    Fair,    iSg^ 

1894.  Villai^e  Sanitation  in  Imlia.  Ke.id  before  the  Trop- 
ical Section,  8th  Ii.ternat.  Cong.  ny.i,'iene  and  Demography, 
Buda])est,  Septeinlicr,  181)4. 

i8q4-  Two  artules  in  Quain's  Dictionary  of  Mediiine. 
"  Xurses:  Training  of,"  "  .Xursmg  the  Suk."  iS()4,  In 
lattT  editions  of  Ouain  these  artii-les  have  been  entirelv 
garbled  by  a  medical  editor  and  their  individuality  is  quite 
lost. 

GKXER.\L   BIor,R.\I>HY. 
Amalie  Sireekint:.      In  (iennan  -TniihenrdiiikeHen  a:i.<!  dem 
Lehen   von.    .M     i:.      \"orwort    \c.n    Dr.    Wiclurn.      ll.imburg, 
i860.      In    French — .Mi  moires  aitthentiqites,   etc.       I'aris  and 
Gene\'a,  1S60. 

*  Mutter  Fliedner    Z:r,n  <Ie,iachtni-:s.     Kaiserswerth.     181)2. 
Life  and  Works  of  I haconess  Harriet  Monsil.      Rew  T.  T. 

Carter.     London. 


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Vo)i  der  Wartung  der  Kranken.      L'nzer,  1769. 


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l')!t,rn',!it   jvr    Kraiikruwartcr,       Fr.inz    M.iy,    Mannln'iip, 


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Hv 
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*  ihc  Young  Mother's  Guide  ai:d  Xursr's  M,ii:uitl.  UN- 
Richard  S.  Kissain,  M.D.      2n(Ud.      llartlur.i,  i.S,.;;. 

*  kriendly  L'autio)is  to  //a   Heals  0/  I-'unulies,  ete.,  witli  Am- 
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*  The  Good  Xurse:  or  Jiii:ls  on  tlie  inaiuii^enient  oj  the  Sick 
Olid  l.yini;-i)i  ('hanih,  r  ai:d  the  Xursery.  Xo  author  iiauu-d, 
London,  1825.      Dedicated  to  Miss  Priscilla  Waketield. 

*  'The  (tood  Soniariton.  or  d  mplete  Knelish  I'hvsieian.  Hy 
Dr.  Lol'i),  mcinlierof  the  Royal  I'olk^je  ol  I'iivsicians  in  Lon- 
don, and  other  cjjxincnl  Practitioners.      London.      .\o  date. 

*  Tlie  Praetiee  oj  the  British  and  French  Hospitals.  A 
Select  Body  oj  nsejul  and  elegant  MciUcines  jor  the  scleral  dis- 
orders hicident  to  the  Human  Body,  etc.     London,  177,^ 

*  The  Science  and  Art  oj  Xursitig  tJte  .'<ick.  Hy  .Eneas 
Munro,  .^LD.     Glasgow,  James  .MacL'hose,  i<S7^. 

*  Accidents:  Popular  Directions  jor  their  Immcdiale  Treat- 
ment. H\-  llenr\'  W'lieaton  Kners,  .Mi).  I'oston,  Thomas 
iL  \Vcl«!'  iV-  Co.,  1845. 

*  Tile  Xurse.  Xo  author  K'^cn.  London,  Hiailston  and 
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*  .4)1  Essay  upon  .Xursing  and  the  .Management  oj  Children. 
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(jlh  ed.      London,  17O9. 

*  Hints  jor  the  .Xursery.  or  the  \'onng  Mother's  Guide.  Hy 
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*  First  Helps  in  Accukiits  and  in  Sickness.  Published  wit  h 
tiio  R'c'omnK'iidalion  of  the  HiL;ht'st  Medical  Authority.  Hos- 
twii.  Ak'xander  Mcjon.' ,  Now  ^■ork,  Leo,  Shcjiard  i!C-  Dillin^'- 
iiam.      1S71. 

*  Till  the  Do.lor  (  nm,^.  By  Georj,'c  H.  Hope,  M.D.  Xow 
York,  ti.   I'.   I'r.tn  nil's  >on-;,    1871. 

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*  lirll.-ene  Mir.iuil.  I'Sy.  Called  '  .\  .Manual  o;  .Vursin.i,'." 
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rial from  a  mann.d  by  .Miss  Zeplierin.i  X'eiteh  and  Domville, 
.M  1).  Also  much  from  Miss  Xi^htinKale  and  Floreiu  e  Lees, 
(..'ompiled  by  Victoria  White,  revised  by  IJr.  Mary  Putnam 
Jacobi.      G.  P.   Putn.ini's  Sons,  Xew  ^'ork. 

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UXITEI)  ST.\TKS  — r,KXF.K.\I.  OCTLIXKS    OF    HISTORY 

*  ".Miss  Linda  liKh.ir'!-;  "  Hy  one  of  her  Pupils.  .-biiiT:- 
eaii  Journal  oj  Xiirsint;,  (  )etober,  igoo,  p.   12  et  seq, 

*  "How  Tr.iined  Xnrsin.t,'  hcjjan  in  America.  Bv  Linda 
Richards.  ,d  )j;lti'<  ji;  I'ournal  of  .Xursini;.  Xo.ember,  njoi. 
p.  S8. 

*  "The  Rel'orni  in  Xursini;  in  Belle\-ue  Hospital."  By  L. 
L.  Dock.  .\meri,an  Journal  0/  .Xursir.f;,  .\'o\'eniber,  igoi, 
It.  S9  et  seq. 

*  "  Larly  History  r)f  the  Boston  Ti.aininf;;  School."  By 
Miss  Curtis  and  .Miss  Dcmiy.  .hneriean  Journa'  of  Xursing, 
February,  i()02,  p.  ;^r  et  seij. 

*  "  Recollections  of  a  Pioneer  Xurse."  By  Linda  Richards. 
.■\nu^riea)i   Journal  of  Xursinc^,  January.    ii).o;,  ]>.   245,  ct  seq. 

*  "A  .\ew  Profession  for  Women."  Century  Magazine, 
July,  1 882. 

*  "History  of  the  Ivstablishmcnt  of  Belle\-ue."  Bv  the 
Manaijers.  Read  at  the  Waldorf-. \stori.i,  March  (),  iS()g,  on 
the  25th  anniversary  of  the  School. 

*  Reports  of  the  Xcii>  York  State  Charities  Aid  Assoeiation: 
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446 


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•■Tramiiii;  Schools  for  Xurses."  By  ("has.  P.  Pufnam, 
Boston.      l\in,  Monthly,  DecLinbt-r,  1874. 

*  .III  ActouHt  oj  H,  ll,''i(c  Hu.spitdl.  kohort  (.'arlislc,  M.l). 
New  York,  i!S();. 

Appendix  lo  tin-  I.ijr  oj  Elizahth  Aiiucs  Jours.  By  her  sis- 
ter. From  the  second  I^mdon  I'liitKui.  (Crmtains  in  ai'pen- 
(iix  an  account  of  Amerii-an  nursing;.) 

*  "T!ic  ( )ri,'anisation  of  Traininj,'  Schools  in  America." 
By  Louise  Darche.     Chi<a:^o  World's  Fair  J 'a f^rrs,  ]•.  518. 

F'T  the  convcnjen.e  of  students,  material  that  may  l,e  foui.l  in  the  re- 
teren.e  library  of  the  Johns  Hopkins  Traiiu-i.;  School  for  N-r^cs  has  l-een 
markeii  With  an  asteri-k.  Tlie  Kreater  pan  of  the  footnote  references  is 
also  to  be  found  thcrv. 


MISrELLANEOlTS 

(Founil  only  in  French  libraries) 

Histoirc  dc  Saint  Crsair  ,   bv      le   alihe  J.    M.    Trichaud, 
Aries,  1853.      Contains  rules  of  the  nuns  n{  Aries. 

L'ancien  Hofital  d'Auhr.i.-.    l,y   the   ahh.'    BMUs.iuet,    Mmit- 

pellicr,  1 84 1. 

Histoirc  Ji-  Saint  RaJci^onlr,  by  the  al.h,'  Brian. i,  Poitiers; 
also  a  large  edition  illustrated. 

i: Hdtd-Dicu  lie  Bcaunc,  1445-1880,  by  the  abbe  \-..  Bavard, 
Beatme,  r88r.      Illustrated. 

La  vie  li-  Mlh:  de  Melenit  (Melun).  by  tleorge  and  Louis 
Josse,  Paris,  1687. 

Histoire  dc  Sainir  ClunUal.   hv  the  abbe   Bou<Mud     P  iris 
1863. 

Us  Swurs  llospitaliercs,  by  Dr.  Armand   Despres,  Paris 


INDEX 


ATii'lard's  instructions  to 
Ht'lf)isi\  i,  I  50 

Air  cushions  anti  rings,  in- 
vention of,  i,  255 

Alexandria,  cirly  hospital 
work  at,  i,  120-12 1 

American  Medical  Associa- 
tion, rei)ort  of  Committee 
on  Training  of  Xurscs.  li. 

Ancient  Rome,  charities  of, 
I.  oo-Qi:  griod-will  of  gods 
in  cure  of  disease,  i,  H4; 
organised  medical  service, 
i,  87-8q 

Angers,  organisation  and 
training  of  Sisters  at,  i, 
426-427 

Animals,  habits  in  illness,  i, 
<)-i  I ;  mutual  aid  instinct, 
i,  1-6 

Anne  of  Austria  as  a  nurse,  i, 
.U<) 

A]  ipliances,  hospital  and  nurs- 
ing. 1,  j.?;,-256 

Arabians  and  hospital  work, 
i,  246  24<) 

.Army  medical  service,  origin 

Association    of    Charity,    es- 

tablishnien,.    f,  i,  407 
Assyrians   and    b.ibylonians, 

disease    theory    of,    i,    58; 

medical  recnnls   of,  1,    56; 

regulations  for  the  practice 

of  surgery,  1.  <;0  -57 

447 


Athelstane,  founder  of  first 
hospital  in  England,  i,  450 

Augustinian  Sisters  at  H6tel- 
Dieu,  Paris,  1,  2()4-,^34; 
in  Canada,  i,  360-38?;  in 
England,  i,  448-457  ;  origin 

of,    I,    2CJ4 

B 

Babylonians  and   Assyrians. 

disease    theory    of,    i,    58; 

medical   records  of,   i,   56; 

regulations  for  the  practice 

of  surgerv',  i,  56-57 
Barber-surgeons,  origin  of,  i, 

477 
Basil,  bishop  of  Cesarea,  work 

of,  i,  123-125 
Basilias,  establishment  of,  i. 

B.ith-tubs,  need  of,  urgeil  by 
Or.  John  (Iregorie,  1.  470 

Be.iune,  description  of  hos- 
pital at,  i,  26f;-27o 

Beds,  canopied,  objection  to, 
!•  253,  255 

— iron,  introduction  of,  i,  242 ; 
objections  to,  i,  ,^55 

— jointed,  tirst  use  of,  i,  253 

— wooden,  in  use  during 
eighteenth  century,  i,  251 

Bed-screens,  portable,  in- 
vention of,  i.  253 

Bedsores,  early  treatment  of. 

Bed-warmers,  early  use  of.  i, 

3i  1      J  C5 


448 


Index 


Beguincs  as  nurses,  i,  264, 
2()S ;  c'hanjjes  among,  i,  271; 
description  of  settlement 
at  Flanders,  i,  262  ;  founders 
of  Sisters  of  St.  Martha, 
of  Burgundy,  1,  270-271; 
freedom  described,  i,  268; 
in  charge  of  hospital  at 
Beaune;  i,  269;  life  of,  i, 
26^^;  opposition  to,  i,  267; 
origin  of,  i,  260-261;  re- 
semblance to  Tertiaries  of 
St.  Francis  and  St.  Domi- 
nic, i,  2()6 

Believue  Hospital,  early  con- 
ditions, ii,  328-^^0;  epi- 
demic of  puer])eral  fever, 
ii,  404;  establishment  ancl 
opening  of  training  school, 
ii.  i^S-i'"^?.  }')A:  investiga- 
tions   and    imi)rovcments, 

>'.  .i.?o-3.?'.  37<J-3«.l.  402- 
40g;  origin,  ii,  32O-32.S; 
})rinciples  of  training  school 
li,  39H-400;  uniforms  adopt- 
ed for  nurses,  ii,  401  ;  work 
of  first  suiJcrintendent,   ii, 

Benedictines,     medical     skill 

of,  i,  154 
Berthcau,  Carolme.  Sec  FMie<l- 

ner,  Caroline 
Bibliography  of  literature  of 

nursing,  u,  437-44O 
Biscot,  Jeanne,     work  of,   i. 

Black  well.  Dr.  Klizabeth, 
work  of,  during  the  Civil 
War,  ii,  358  ,?5<>.  3O1-3O3 

Bleeding  anil  cuppmg,  pr.ic- 
tice  of,  by  savages,  i,  24 

Blockley  IluS]>ital,  early  con- 
ditions, li,  33»-33S;  origin, 

Bon  Secours,  origin  of,  i,  a8() 
Bouquet,  Genevieve,  rcfonner 

of  nursing  at  Ilotei-Dicu, 

Pans,  i,  321-324 
Bowdcn,  Miss,  letter  to  Tr.iin- 

ing     School     ;it     Helle\  ue 

Hospital,   ii,  411;  work  at 


Believue  Hospital,  ii,  -  ,4- 
3()6 

Bracelli,  Virginia,  founder  of 
Daughters  of  Our  L.idy  of 
Mount  Cah'ary,  i,  33Q  ' 

Brignole,  Emanuele,  reform- 
er of  Daughters  of  {;ur 
Lady  of  Mount  Calvary.  1, 

Brothers  of  .Mercy,  descrip- 
tion of  order,  i,  342.  duties 
of,  !,  340;    founding  of,    i, 


Camillus,   foumler  of  Clerks 
Regular  and  Camellines,  i, 

Catherine  of  Genoa  as  a  ni  ,-se 
^  i,  3»S 

C  elli,  Angelo.  investigation  of 
Italian  hospitals  by,  i.  513 

Cesaria  and  Ces;irius,  work  of, 
i,  158 

Ceylon,  hosjiitals  and  chari- 
ties of,  i,  43-45 

Chalon  -  sur  -  fc.aone,  descrqi- 
tion  of  hosi)ital  at,  i,  270 

Chariti'JS  Aiil  A.ssociatioii 
of  New  York  State,  de- 
partments of,  ii,  ^71 ;  in- 
vestigations of  Ik'llevue 
Hospital  by,  ii,  376-383; 
organisation  of,  "li,  371; 
work  of  Hospitals  Com- 
mittee, 372-388 

Children's  epidemics,  I'lor- 
ence  Nightingale  on,  ii,  215 

Christian  nursing,  beginning 
of.  1,  100 

Ciudad,  Jean,  founcler  of 
Fate-bene-Fratelli,  1,  337 

Civil  War,  orgiiiisation  of 
S.initary  Commission,  ii, 
355*;  work  of  Dorothea 
Lynde  Dix,  ii,  363-365; 
work  of  Dr.  Llizabeth 
Blackwell.  II,  358-350,  361- 
362  ;  Work  of  Louisa  Schuy- 
ler, 11,  358-360 


Index 


440 


'4- 


".  iiL'Scnp- 
!42  ,  diitii'S 
ding  of,    1, 


''Icrks  Rr.milar.  Ministers  of 
ihf   Infirm,  foundinj,'  of.   i, 

(  lothing  of  licil  p.itn'iits  :n 
early  hospitals,  i,  255 

C'onnecticut  Training  School, 
found.ition  of,  ii,  424-4^^2 

''ontatjion  in  crowded  wards, 
1,  250 

Correspondence  with  earlv 
Enj^lish  hospitals  regard- 
ing S])iritvial  care  of  i)a- 
tients,  i,  50() 

"t-'ottage  Nursing,"  attempt 
at,  i.  4(),S 

Cow's  milk,  tirst  use  of,  for 
inf.uits,  1.  24? 

Cra\en,  Mrs.  Dacre.  work  of, 
ii,  2()S-  ^oo 

Crimean  War,  conditions  at 
Scutari  hospital,  li,  121- 
124.  1 58-141;  demand  for 
nurses,  ii,  1 14-1  ift;  ex- 
tracts from  the  writmgs 
of  a  Lady  Volunteer,  ii, 
1^54-1.^5,  137-14 1 ;  Florence 
Nightingale  on  conditions 
of  the  British  Aniiy,  li,  224- 
2,51;  hardshii)s  of  nurses 
at  Scutari,  ii,  140-141; 
lack  of  medical  care,  ii,  i  14- 
iiS;  work  of  Florence 
Nightingale,  ii,  101-171; 
work  of  nursing  statT,  ii. 
I  !;6    if) I 

Crusade,  nursing  during,  i, 
I  7  5  - r  Ko 

Culjieper,  Nicholas,  extracts 
from  Pharmacopria  l.on- 
dincwsis,  i,  4H5-4S7 

1) 

Dimes  de  C  h.inle,  org.iiiis.i- 

tion  of,  i,  412,   413 
D.inish  field hosj)itals in  1758, 

regulations  of^,  i,  513 
Dark    jH-riod   of    nursing,    i, 

4<)9- .';24 
Daughters   of   our    Lady    of 

Mount   Calvary,    founding 

of.  i,  iH) 


Deaconess,  The.  pulilicatif)n 
of,  i.  542 

Deaconess,  title  of,  opposed 
hy  I'astfir  Cossner,  1,  543 

Deaconesses  {sec  also  Kaisers- 
werth)  ap])ointed  by  Mora- 
vians, i,  521);  decline  of 
standards  among,  ii,  47, 
description  of,  by  Wil- 
helm  Liihe,  i,  116;  ear- 
liest work,  i,  10 1 -106;  em- 
ployed by  presl)ytery.  i, 
527;  first  schcjol  for,  ii,  3, 
founders  of  nurses'  calling, 
i.  115;  growth  of  order.  1, 
103;  in  ancient  Rome.  i. 
133;  in  Ciermany,  i,  527; 
in  Holland,  i,  528-520: 
opposition  to  intVllectu.tl 
life  among,  ii,  48-50:  ple.i 
for  return  of,  by  Johann 
Klrtnne,  i,  541 ;  resemblance 
to  Sisters  of  Charity,  11, 
3 5-3*^;  training  described 
by  Schafer,  ii,  30;  visiting 
nursing  bv,  i,  52S 

d'Aguillon,  Duchess,  founder 
of  Hntei-Dieu  at  (Juebec,  i, 
368 

de  Bouillon,  (iodtrcv,  work 
of,  1,  i77-'7<» 

de  Bresoles,  Judith,  work  of, 
at  Montrc.d,  i,  3(^5 

de  Chantal,  Mme.,  as  a  visit- 
ing nurse,  i,  35  i 

de  Cloussalt,  .Mme.,  work  of, 
i,  412   413 

de  Marillac,  Louise  (.Mile  Ic 
(jras),api)earance and  char- 
actor,  i,  434;  deilication  by 
vow  to  charitable  work,  1. 
420;  early  work,  i,  418; 
first  call  to  hos])ital  service 
i,  426 

dc  Melun,  Mile.,  as  a  nurse, 
i.  34<) 

Desault,  criticisms  of  hosju- 
tal  service  at  Uotel-Dieu, 
Paris,  by.  i,  328 

Diakonias,  or  home  ho!i])itals, 
establishment  of,  i.  118 


4  5° 


Ind 


c\ 


Dicflcnbach.   Z     T..    nursinij 

manual  hv,  i,  5^8 
Discipliiu'  of  luirsi's,  I'loicnco 

N'if,'htinjiale  uii.    ii.    2f>4 
Disease  as  an  f\  il  s])irit,  l)c- 


lit'f  in,  i.  14.  15- 


■iS. 


J2,  5S;  as  jiunislinu'nt  for 
sin,     i,     58;     witches    and 
sorcery  in,  i,  r4,  i6-.>i.    \^ 
Disinfectants,  early,    i,    251 

Disinfection  as  recommended 
by  DictVenh;icli,  i,  5_5<; 

District  nursing  {sec  also 
Visiting  nursing),  estab- 
lishment of,  at  K.iisers- 
wcrth,  ii,  ,^0;  first  example 
f)f.  i,  102;  impro\emen»  in, 
ii,  2()iS 

Dix,   I)orf)tli>',i   Lyivl  I, 

of,  ii,  ;;()?   ^65 

Dun.mt,  Henri,  originator  ol 
Red  Cross  Stjciety,  ii,  314- 
315 


Early  Christians  and  hospital 
work,  i,  g5  - 14^ 

Early  English  nursing,  i,  441- 
476 

Egyi)tians,  hygienic  rul'.'s  of, 
i,  5J  S3;  meflic.-d  records 
of,  i,  47-40;  nursing,  medi- 
cine and  suri;ery  of,  i,  47- 
5S;  s,initary  laws  of,  52   5.^ 

Elizalieth  of  Ilungarj-,  work 
of,  i,  3  18-223 

Elizabeth,  (Jueen  of  Portugal, 
in  hospital  work,  i,  3  j8 

English    (early)    nursing,    i, 

441  _47''> 
Engl-  \\   system    (jf   nursing, 
gradual  changes  in,  ii,  304 

3  n 

English  training  schools,  ser- 
vant-nurse in,  ii,  1S4    i.s^ 

Epidauros,  ancient  cure  at,  i, 
7'-74 

Epidemics  at  nuebcc,  i,  3O0- 


Extracts  from  Ambroiso  P,i- 
re's  di;iry,  i,  480-4.S5;  from 
1"  lorence  X  igh  t  ing.i  le  's  wr  it- 
iiigs,  ii,  208-223.  224-237, 
241  25')-  260-286;  from 
John  Howard's  La:arettos 
and  Hospitals,  i,  506-508; 
froTn  Nicholas  ("idpe])er's 
/ 'Ihirmaropiia  l.oiitliiuiists, 
i.  4f<5-;'*^7;  from  1  he  Good 
■'^aiitarUai:,    ,  490-4(;7 


I'.ibiola,    description    of,   by 

Jerome,  i.  138;  hospit.iland 

_  nursing  work  of,  i,  137 

Fate-bene-Fratelli,    found 'ng 

of  order,  i,  337  ;  growth  and 

_  work,  i,  337-33'** 

l"irst  hospital  in  England,  i, 

,  ^^° 

Fliedner,  Caroline,  character 
of,  ii,  26 

Fliedner.  Friedcrike,  .issuper- 
intendent  at  Kaiserswerth, 
ii,  16-18,  i(>-2i;at  Dussel- 
I  dorf,  ii,  8;  first  woman 
writer  on  the  training  of 
nurses,  ii.  18;  first  work  at 
Kaiserswerth,  ii,  g;  organi- 
s.ition  of  nursing  work 
outside  of  Kaiserswerth, 
ii,  2 1 

Fliedner,  Theodf)r,  advocate 
of  w<jmen  teachers  in  pub- 
lie  .schools,  ii,  34;  estab- 
lishment of  refuge  for  jiris- 
oners  by,  ii,  10;  founding 
of  Rhenish-Westph.ilian 
I'rison  Association,  ii,  6; 
journey  to  H<jlland  and 
England,  ii,  5;  resemblance 
to  Vincent  de  Paul,  ii,  35; 
\isit  to  America,  ii,  31 

Flower  .Mission,  establish- 
ment of,  ii,  203 

Foundling  hospitals.  5ce 
Hosi>itals,  foun<iling 

Fr.mces,  Duchess  of  Mrittany, 
I       us  a  nil'-'   '    •  I') 


Index 


451 


French  hospitals  in  Amrrica. 

i,  ,?55  -402 
Frieniilv   visiting  tstablishcd 

liy    Aiiialic    Sic\'ok:iii,'.     i. 

546-54S;  Florence  Nii^luin- 

jjalc  on,  ii,  2,^7 
Friends,     Society    of.        5ct' 

(Juakers 
Fry,    Elizabeth,    influence   of 

kaiserswerth     u[i()ii     work 

of,  li,  72 ;  visit  of  Theodor 

Flicdner,     ii.     (> ;     \isit     tu 

Kaiserswerth,  11,   Ky,  work 

of,  ii,  70-76 


Gabrielc,  story  of,  ii,  50-60 

'tene\a  Treaty,  adoption  of, 
11,  ,^  1 6 

Ciobel,  Kathcrine,  at  Kaisers- 
werth. 11,  10 

(looch,  IJr.,  on  the  training 
of  nurses,  li,  65-6O 

Good  Samaritan,  extracts 
from,  i,  4QO-4g7 

Oossner,  Joh.mnes,  work  oi, 

,  i.  543 

Greece  and  e.irly  medicine,  1. 
67-82;  early  exampiles  of 
hospital  work,  i,  70-72; 
early  medical  schools,  i, 
75:  teachings  of  Aret.Tus, 
i,  7Q-82;  teachings  of  Mip- 
pwratcs,  i,  76-77 

Greek  physicians,  teachings 
of,  i,  76   77,  7()  82 

Gregorie,  Dr.  John,  on  need 
of  bath-tubs  in  hospitals, 
1.  470 

H 


Health  and  nursing  the  well. 

Florence    Nightingale    on, 

ii.  269-271 
ileliMse,  nursing  under,  i,  157 
Ihldegnrde,  work  of,   i,   16a- 

170 


Hindoos,  early  examples  of 
municipal  hosintals among, 
i.  s.i ;  extracts  from  writings 
of,  1,  32-,u>;  hygienic  rules 
of,  i,  ^i;  inoculation  for 
sinalI-])ox  among,  i,  38-39; 
medical  writings  of,  i.  2g, 
37;  rules  for  nurses  and 
physicians,  i,  32:  rules  re- 
l.iting  to  surgical  ojiera- 
tiors,  i,  36-37 

Hippocrates,  teachings  of,  i, 
76-77 

Home  life  for  nurses,  Florence 
Nightingale  on.  ii,  272- 
27,^, 

Hosjjital  .and  nursing  apph- 
ances,  i,  23,^  -256 

HosjiiLil  construction,  im- 
provement in,  i,  254;  oli- 
iiterated  by  scientific  work, 
'•  255 

Hospital  management,  ab- 
sence of  women  in,  i,  490  - 
506;  criticisms  of,  by  John 
Howard,  i.  471-476,  517- 
524;  criticisms  of,  by  \Vill- 
i.ini  Nolan,  i,  504 

llospit.il  training  for  nurses 
.it  Elizabeth  Hosjntal,  Her- 
lin.  i,  543 

Hospitals: 

Alex.inflrian,  i,  1  29 
Alsace,  i,  161 
Ar.ibian,  i.  246-249 
Aries,  i,  i  5S 
Canada : 

Hotel-Dieu,  Montreal,   i, 

38,,-388,  7,m 
Hotel-Dieu,    (Jue'iec,    i. 

3SS-3<>8.  38 > 
St.  Ci.thcrine's   General 
an'i  Marine  Hospital, 

".  3,^4-355 
Constantinople : 

Hospital     of    St.     John 

Chrysostom,  i,  127 
Jewish  Hospital,  i.  523 
ICngland: 

Hospital  of  Herbaldown, 
1.  45' 


Tndtx 


Ilnspilals  {Continued)- 

Hospital  iif  St.  (.lilos  in 

the  Ivist.  i.  4>  I 
Hospital  (,f  St,  John  the 

Baptist,  i,  45  i 
Hosjiital  of  St.    Katlicr- 

ino.  i,  452 
Hospital  of  St.  Peter  and 

St.  Leonard  at  York,  i, 

45° 
Middlesex     Hosjiita',     i, 

47 '-47') 

N'orfolk  and  Norwich 
Hospital.  I,  476 

St.  Bartholomew's  Hos- 
pital, i,  452,  4.S5-4S7. 
461-465  ;   ii.  ,304-^  I  I 

St.  Bartholomew's  hos- 
pital  for     Lepers,      i, 

451 
St.  Thomas's  Hospital,  i, 

462,  463.464,466-467; 

ii.  181 
?"  ranee : 

Hopit.il  des  Petites  Mai- 

sons,  1,  522 
Hospital    at    Beaiine,    i, 

260-270 
Hospital  at   (."halon-sur- 

Saone  1,  270 
Hospital    of    St.    John, 

Brussels,  i,  520 
Hospit.d  of  St     Louis,  i, 

522 
Hospital   of    the    Salpc- 

triere,  Paris,  i,  521 
Hntel-Dieu,     Lyons,      i, 

jSi  -292 
Hotel-Dieu,  Paris,  i,  aga- 

.VV5 

La  Conitessc  Hospit;il, 
Lille,  i,  521 

St.     Sauveur     Hospital, 
Lille,  i,  531 
Germany : 

CharitY'  Hospital,  Berlin, 
ii,   26-2H 

Elizabeth  Hospital,  Ber- 
lin, i,  54.? 

Hospital  at  Neumarkt 
for  1i>i,irs    i,  220 


Hos))it;d  of   .M.ina    M.ic- 

d.ili'n.i,  1,  22_5 
Hospital  of  St.  Barb.'ir.i, 

i.  24() 
St.    Peter's    lI()S])ital    in 

Prai^ue,  i.  226 
Ireland : 

Maryborough  Infirmary, 

i.'5-2.^ 
Italy: 

Hospital  of  the  Hen  Fra- 

telli,  Naples,  i.   51Q 
Hosj)ital  of  St.  Esprit  at 

Dijon,  i,  238 
Hospital  of  Santa   Maria 

Annunziata,  i,  245 
Ospedale  C"u  ile,   \'eniee, 

i,  24  I 
Osiiedale     Maggiorc     of 

Milan,  i,  241 
Santa  Maria  Nuova.  Flo- 

renee.  i,  24  i 
Santo   Spirito  m   Rome, 

'•  •s.U.  23S-*3S 
Jerusalem : 

Holy        Infirmary         of 

Knights  of  St     John. 

i.  u;5~20!; 
Hosjjital  of  St.  John  the 

Almoner.     174-175, 

170,  183-185 
Hospital     of    St      Mary 

Magdalene.  1.  i  74 
Lnited  States: 

Bellevue     Hospital,      ii, 

326-331,376-387,394- 

3g6,  3()8-40() 
Massachusetts,     Clencral 

Hospital  ii,  412   42 1 
New    Ivngland   Hospital 

for    women   and   ehil- 

dren.  ii,  346-353 
New  York    Hospital,   ii, 

Pennsylvania  llospit.i!  n, 

3  3  5-.?.?  8 
Woman's  .lospital,  Phil- 
adelphia, ii,  346 
Hospitals     a     part     of     the 
Church,    i.    123,    155,    iS7i 


Index 


45. 


Man- 


Hospitals  huilt    by    Fabiola. 

Ho'^t'itals   Imill   by    Paula,   i, 

140 
Hoapital-S,     early,     and     tin' 

RoiTi'in  matrons,  i,i  18-14^ 
Ho.iiJitals,  founiilmg: 

(Mphan   House  established 
bv  IvinperorAlexius,  i,  127 

( )spedala  Santa  Maria  dej,di 
InnoL'enti.  i.  242-24^^ 

Santa  Maria  dolla  Scala,    i, 

24.5-245 

Hospitals,  historic,  architec- 
ture of,  i,  23S-240,  241-24  , 

Hotel-Dii'u  Lyons,  found- 
ing of,  1,  281  ,  medical  serv- 
ice, i,  282;  nursing  service, 

i,    2S3-2()2 

Hotel-Uieu,  Montreal,  de- 
scription of,  i,  -.i)-.;  found- 
ing, 1,   ■>,ii&;  origin,  i,    18^- 

Hotel-Dieu,  Paris,  early  con- 
ditions, 1,  32<)-333 ;  enlarge- 
ments of,  1,  2()3;  founding, 
1,  2g2;  hospital  scr\ice 
criticised,  i,  328;  improved 
conditions,  i,  .v^j;  influence 
of  Gene\  leve  Houfiuet,  i, 
321-324;  investigation  by 
iiN'il  authorities,  i,  310; 
lepers  excluded,  i,  293, 
nursing  service,  i,  295-334; 
overcrowding  of,  i,  304, 
328;  visits  of  Dames  de 
t'harite,  i,  323 

Hotcl-Uicu,  (^uebec,  found- 
ing of,  i,  568;  growth,  i, 
381,  origin,  i,  355-3''7 

Hot  water  jugs,  use  of,  i,  252 

Howard,  John,  criticisms  of 
hospital  management  by, 
i,  203-205,  471,  476,  517- 
524;  extr.acts  from  Lazaret- 
tos and  Hospitals,  i,  soft- 
ie; 08 

Hygiene  of  ancient  Hindoos, 
i.  3°-35;  of  early  Egyp- 
tians, i,  53-53;  of  Jews, 
i,  01-66 


India  (sec  also  Hindoos), 
nursing,  medicine,  and  sur- 
gery of,  i,  20-4  I 

Inoculation  in  small-pox, 
jiractice  of,  by  ancient 
Hindoos,  i,  30.  38-39;  by 
savages,  i,  24-  25 

Institute  of  Nursing,  at  Dev- 
onshire, establishment  of, 
ii,  7.'^ 

Isabel  of  Castile  as  a  nurse,  i, 
.U8 

Italian  hcjspitals,  architect- 
ure of,  i,  238-240;  inves- 
tigation of,  by  Angelo 
Celli.  i,  513;  worksof  art  in, 
i,  23ft,  238,  241 


J 


J.amme,  Anna  ('.,  Extract 
from  Thr  First  Traiiiiny, 
School  in  Amcriia,    bv,    11, 

,   353 

Jesuits  at  (Juebee,  i,  355-367 

Jews,   charities  of,    i,   64-O5; 

hygienic   laws  of,   i,   61    (14 
Jones,  Agnes  Elizabeth,  work 

of,  296-298 


Kaiscrswerth  and  the  deacon- 
ess movement,  ii,  1-61; 
division  of  work,  ii,  \(>; 
early  reports  of  work,  ii, 
29-31;  establishment  of 
district  nursing,  ii,  30;  in- 
fluence u[>on  modern  train- 
ing schools,  ii,  40;  opening 
of  hospital,  ii,  13;  original 
inKtitution,  ii.  10;  prep.ara- 
tory  instruction  of  nurses, 
ii,  30-31,  40-41;  ])rinciples 
of  the  Fliedners,  ii,  31-32; 
refuge  for  prisoners,  ii,  10; 
routine  life  of  nurses,  ii, 
41-44;  treatment  of  pa- 
tients, ii,  34 


454 


Index 


Kaisers  worth  Dciconcsst-s' 
Instilution,  furinal  tiiarUr 
}>;rantc'd.  ii,  ^i 5 

Kaisers  worth  tioneral  ("on- 
foronoo    of    Mothorhcjusos. 

>i.  35 

Kinji  s  (iillo;^o  Hospital,  ihl'- 
lioultios  witli  St.  John's 
House,  ii,  (;v  ()4;  nursintj 
undertaken  i>y  St.  John's 
House,  ii,  ()o-()i 

Klonne,  Johann,  impraeti- 
ealiihty  of  \iows  on  train- 
ing of  nurses,  i,  541;  pam- 
phlet by,  1,  540 

Knights  of  St.  John,  di\ision 
of  i,  1S4;  estahlishnient 
o  Order  in  England,  i, 
105;  foraalo  branch,  i,  i.So; 
hospital  service  at  \',dr!ta, 
i,  146-205;  origin,  i,  175; 
rules,  i,  1S6;  work  during 
Crusade,  i,  i<j4-i<;5 

Knights  of  St.  Johii,  Holv 
Intinnary  of,  criticisms  bv 
John  Howard,  i,  jo^-205; 
description,  i,  i()(i;  duties 
of  ofticers,  i,  u)--2o;,; 
origin,  i.   ig; 

Knights  of  St.  L.azarus,  origin, 
i,  i'jo-i()2;  work,  i,i92 


Ladies  of  Chanty,  directions 
for  work,  1,  40S 

"Lady   j)robationer  ■'   of   the 
Engbsh  hospitals,  ii,  206 

Lanfranc.  Archbishop  of  Can- 
terbury, work  of,  i,  451 

le  Begue,  Lambert,  imi)rison- 
ment  of,  i,  2(15;  work  of,  i,   ., 
261  1 

Lees,  Florence.    .S'lV  Craven,   | 
Mrs.  Dacre  ; 

ledras,  Mllo.     See  de  M.anl- 
lac,  lionise 

le  Joune,   Father,  appeal  for 
liospital  at  Quebec,   i,    ^o; 

le  Pailleur,   Sister,   work   of. 
i-  399 


Loiieintre,  Jeanne,  .at  Xantes, 

1,   4-^1) 

Lepers  excluded  from  Holcl- 
IJieu,  Pans,  1,  203;  hosjutal 
for,  established  "by  Basil, 
i,  12,:;,  St.  Bartholomew's 
Hospital  for,  i,  451;  St 
Francis  of  Assisi  among,  i, 
210;  work  among,  i,  162 

Loilge,  Thomas,  on  require- 
ments of  a  contagious 
hospital,  i,  454 

Lc'ihe.  Wilhelm,  on  the  work 
of  De.iconessos,  1,  1  1  0 

M 

Macrina,  sister  of  Basil,  work 
of,  i,  12O 

^Llnee,  .Mile.  Jeanne,  estab- 
lished at  Hi'itel-Dieii.  Mon- 
treal, i,  3gi;  founder  of 
H'''tel-Dieu,  .^Iontreal,  1,  ^.S  :; 

JL-"iS,  hostility  toward  Sisters 
at,  i,  430 

^Lu•colla.  leader  of  charity 
and  nursing  work,  i,  1  :;  5 

^L^ria  Theresa.  Sister,  lion- 
ours  presented  to,  i,  440 

^Lirtin,  Anselm,  directionsfor 
]iers(jnal  care  of  jiatients,  1, 
254 

Mass.ichusetts  Cunoral  Hos- 
pital, early  days  of  train- 
ing school,  ii.  416-421  ; 
establishment  of  tr.uiiing 
school,  ii.  4  I  2-4  I  5  :  Work  of 
Woman's  Educational  .As- 
sociation, ii,  41  2-414 

^Li..oage,  practice  of,  by 
ancient  Hindoos,  i,  30;  by 
ancient  Romans,  i,  88; 
by  sa\-ages.  i,  22 

Mattresses,  hair,  first  use  of, 
'.  2.S3 

May.  Franz,  establishment 
of  course  of  instruction  for 
hospital  attendants,  i,  536; 
on  nurses  and  nursmg,  i, 
5,Ci"5,^7;  opposition  to 
work  of,  i,  537 


Ind 


ex 


45 


o.-> 


Meals,    serving    of,    in    t-arly 

lujspilals,  i,  255 
Mtilia-val   nursing  orders,    i, 

Medi.e\-al   sur^'cry  and  med- 
ical  treatment,   i,   447-4()8 
Medical  books,  early,  i,  4S8- 

4Q0 

Medicine,  instruction  in,  in 
connection  with  monaste- 
ries, i,  I  52;  ]>ractice  of,  by 
ancient  Romans,  i,  S^-rjj; 
]>ractice  of,  by  ancient 
Greeks,  i,  67-82;  practice 
of,  by  early  I-^gyptians,  i, 
47-55;  practice  of,  by 
monastic  orders,  i,  i  ;  ^ 

Medicine-man,  development 
of,  i,  14-1  5,  20-21 

Men  as  nurses,  i,  101 

Mexico,  old  Spanish  hospitals 
in,  i,  402 

Middlesex  Hospital,  England, 
economies  of,  i,  474;  ex- 
tracts from  minutes,  i,  475— 
476;  regidations,  i,  473-474 

Monastieism,  first  oxamjilc 
of,  i,  136;  rise  of,  144-170; 
rules  oQvcrning,  i,  144 

Monastic  orders  and  the 
liraclice  of  medicine,  i,  153 

More,  Ilannali,  iii(lu(  nee  of 
life  on  develoi)ment  of 
reforms,  i,  5  u 

"Mother  of  the  Poor"  (Mme. 
de    Lanioignon),    i.    400 

Mothers  as  nurses,  Floreiu  e 
N'lghtingale  on,  ii,  2!f)-26^ 

Municipal  control  of  Ii;nglisii 
hospitals,  i.  4   0-461 

Miinster,  Friedtrike,  Siv 
Fliednei    Friedenke 

X 

Nantes,  installation  cf  Sisters 

at,  i,  42() 
Napoleonic  war,  influence  on 

nursing  reform,  i,  540 
N'utional     Nursing     Associ  1 

tion  lilngland,  organisation 

of.  ii,  2';v-;,oo 


Nazeau,  Marguerite,  one  of 
the  first  Sisters  of  Charity, 
i,  421 

Neale,  R.  v.  Dr.,  founder  of 
St.  Margaret's  Sisterhooij, 
ii,  y6 

New  England  Hosj)itaI  for 
Women  and  Children,  be- 
ginning of  nursing  work,  ii, 
340-,?4g;  establishment  of 
training  school,  ii,  341), 
extract  from  account  of,  ii, 
353;  extracts  from  early 
rei>orts,  ii,  34^-351;  re- 
quirements for  admission 
to  training  school,  ii,  350 

New  Y(jrk  Hospital,  estab- 
Ishment  of,  ii,  33H;  estab- 
lishment of  training  school, 
ii.  .v^') 

Nightingale,  Florence,  at 
Kaiserswerth,  ii,  2g,  31, 
1 12  ;  at  Scutari,  ii,  120-143; 
comments  on,  from  King- 
lake,  ii,  131-133;  co-work- 
ers of  ii,  287-311;  descrip- 
tions of.  ii,  1 2  7-1 3  I  :  educa- 
tion of,  ii,  io5;extractsfrom 
writings  of,  ii,  20S-223, 
224-237,  241-25Q,  260- 
2S6.  388-3()3;  memorial  of, 
Mrs.  W.irdroper  by,  ii, 
ioo-i<;4.  note  on, 'from 
JuHa  Ward  Howe's  Rciit- 
i)ii.sccnci-s.  ii,  iio;  note  on, 
from  Caroline  Fox's  Mem- 
oirs, ii,  105-106;  on  "chil- 
dren's epidemics,''  ii,  215; 
on  onditionsof  the  British 
.Army,  ii,  224-231;  on 
dangers  in  the  nursing  pro- 
fession, ii,  273-277;  on 
discipline  of  nurses,  ii,  264; 
on  essentials  of  a  goo(i 
tiainingschool,  ii,  265-267; 
on  essentials  of  health,  ii, 
213-214;  on  friendly  visit- 
ing, ii.  237;  on  future  of 
nursing,  ii,  27S  2S0;  on 
lie.ilth  and  nursing  the 
Well,  ii,  260-271  ■  on  home 


456 


Ind 


ex 


Xighlingalo,  Florence  (Conf): 
1:10  tor  nursi'S,  ii,  272-27,1", 
on  lack  of  considcral  ion  for 
nurses,  i,  516;  on  mothers 
as  nurses,  ii,  261  2(1,;;  on 
nursinj,'  as  a  "callinj,',"  11, 
272;  on  observation  in 
nurses,  ii,  210-221;  on 
position  of  nursing  super- 
intenilent,  ii,  250-252:  on 
]mjper  teaching  of  oli- 
stetrics,  ii,  21,11;  on  ]>r(i]ier 
ventilation,  ii,  211-212; 
on  quiet  in  the  sick  room, 
ii.  216;  on  reading  aloud 
in  the  sick  room,  ii,  21.S; 
on  requisites  of  the  nurse, 
ii,  257-259,  275;  on  sanita- 
tion in  India,  ii,  2.^2-2,^7; 
on  systems  of  nursing  ex- 
isting in  iS()2,  ii,  241-241); 
on  theory  in  nurses'  train- 
ing, ii,  274-275  ;  on  training 
of  nurses,  ii,  2()3-2()7,  274- 
280;  on  training  of  ^jroba- 
tioiuTS,  ii,  252-25?;  on 
unity  amf)ng  nurses,  li, 
277-27S;  visit  of  Sidney 
Herbert  to,  ii,  1 1  j; :  work  of. 
during  the  Crimean  War, 
1 01-17 1 ;  writings  of,  ii,  207, 
286 

X'Ightingale  Home  and  Train- 
ing School,  i,  402 

Xightingale  School  for  nurses, 
brief  principles  of,  ii,  192; 
class  distinction  in,  ii,  igg- 
206;  compenr.ation  to  pupil 
nurses,  ii,  kji):  general  filan 
of,  ii,  1S2;  intluence  of,  on 
nursing  reform,  ii,  i<S?-i86, 
206;  length  of  course,  ii, 
iq8-i()o;  obstetrical  train- 
ing established,  ii,  25S; 
opening  of,  ii,  181;  opposi- 
tion to.  ii,  176-181;  plans 
for  establishment  of,  ii, 
172-176;  theoretical  teach- 
ing, ii,  200-201;  training 
described  by  Dr.  Gill  Wy- 
lie,  ii,  202-20! 


Xolan,  Willi.im,  criticisms  of 
hospital  management,  i, 
504 

Xursc  Society  of  Philadel- 
phia, instruction  of  pupils, 
ii,  ,iir,  organisation  of,  ii, 
34i-,?42;  work  of,  ii,  342 

Nursing,  absence  of,  during 
early  e[)idemics,  i,  45,;; 
anions,'  sa\'age  tribes,  1. 
21  25;  as  a  "calling." 
l-"l(;ren(.e  .Xightingale  on, 
ii,  272;  as  a  ]ienance  lor 
sins,  i,  I  ^} ;  by  lirimitiNe 
m.in,  i,  12-25;  I'y  private 
individuals,  i,  i_^5,  137,  141, 
4(17;  by  religious  orders 
(.v<v  Xursing  ortlers);  by 
royalty,  i,  157-1 5(),  ,v48- 
340;  Iiy  .saints,  i,  210  2,2; 
combined  with  duties  of 
soldier,  i,  18,^-185;  decline 
of  standards  of,  i,  411(1-500 ; 
development  of,  in  Amer- 
ica, ii,  32()-?(K);  during  the 
('hristian  ])eriod,  i,  100; 
during  the  Crus.adcs,  i,  17S; 
during  the  ]ire-('hristian 
period  i,  i-()2;  e.arly  I'^ng- 
iish,  i,  441-470:  earliest 
examples  of,  by  early  Chris- 
tians, i,  120;  in  America, 
develoj)ment  of,  ii,  326- 
361);  in  ancient  Greece,  i, 
81-82;  in  ancient  Rome,  i, 
88;  in  Ceylon,  i.  44-45; 
in  India,  i,  32-33;  in  work- 
hf>use  infirmaries,  ii,  294; 
instruction  in,  in  connec- 
tion with  monasteries,  i, 
152;  neglect  <if,  i,  460 

Xursing  orders: 

.\ugustinian  Sisters,  i,  294— 

,^3•^.  3'")- .",83,  44S,  457 
Hcguines,  C)rdcr  of,  i,  259- 

27.^ 
Brignoline  or  Daughters  of 
our  Ladv  of  .Mt.  Cah  arv. 


Brothers  of  Mercv.  i, 
342 


?40- 


Index 


457 


N'lirsins;  orders  {Coutiuurd) : 
I  'ar.iflliiU'S,  or  Uau.ijincrsdl' 

Sf    ( 'amilhis,  i.  ,538-  3  ;(> 
I'atL'-lii.Tic-I'ratflIi,     ( irder 

Filles  (le  la  SaKossc,  i,  344 
I-Vanciscans,  Orilcrof,  i,  2  i  o 
(Iruy   Sisters,    OnliT   of,    i, 

Ilornianiiad    dol     RffuL;io. 

Society  of,  i,  343 
Kiiif^lits  of  St.  John,  i.  1  75. 


i7()-i.S-. 
Knifjhts  of 

i()o-icj4 
St.     [(jsepli 

Order  of. 


n)4  -201) 

St.   Lazarus,  i, 

•  Ir    la     1-ivehe, 


1.  27.S 
Holv 


1.  .i<)4 
St.  Vincent  de  Paul,  Order 

of,  i,  345,  42:!-420,   421, 

431.  430 
Santa   Maria  Xiiova 
Santo      Spirito,     or 

Ghost,  i,  274-^76 
-'istcrhood  of  All  Saints,  ii, 

Sisterhood  of  tlic  t'oinnioii 

Life,  i,  273 
Sisterhood  of  the  I'lior  ('lar- 

isses,  i.  2  1  4-2  i() 
Sisterhood  of  St.  .Marj,'aret, 

ii,  ()6  -()() 
Sisters  of  the    Presentation 

of  the  Holy  Virf^in,  i,  344 
Sisters    of    St.    Charles    de 

Nancy,  i,  343 
Sisters    of    St,    .M..rtlia    of 

Hurtjundy,  i,  27  i 
Third  Order  of  St.  Francis, 

i,  217-218,    },7,q 

Teutonic  Knifjhts,i,i8i)-i()o 

Visitation  of   M.irv,   ( )rder 

of,  1,  352 

Xursing   orders,   later   niedi- 

anal,  i,  336-354;  military, 

i,    17  l-20() 

Xursinj^  profession  .dangers  in, 
I'lorence  Xightingale  on, 
ii,  272-277  ;  future  of,  Flor- 
ence Nightingale  on,  ii,  278 
-280;  unity  in,  Florence 
Nightingale  on,  ii,  277-278 


Xursing  reform,  influence  of 
.X.ipoleonic  war  on,  i,  540; 
inlluence  of  Xighting.ile 
School  on,  ii.  183-186,  206; 
medical  jirofession  in,  11, 
366;   ojijiosition   to,    i,    537 

Xursing  Sisters  at  Devon- 
shire, training  of.  ii,  73 

Xursing  systems  existing  in 
18(12,  I'Torence  Xightin- 
galc  mi,   ii,   24 1-241) 

o 

Observation  in  nurses  urged 
by  I'lorence  \ighl:ngale,  li, 

2  I()-221 

Orders  of  early  women  work- 
ers, i,  100 

Organised  charity,  founding 
of,  i,  410 

Orleans,  inefiicient  care  of 
sick  at,  i,  415 

(Jsborne.  Kcv."  Sydney,  ac- 
count of  hospital  con- 
diticjns  at  Scutari,  ii.  121- 
125;  description  of  Floi- 
cnce  XightingaJL-,  li,  127- 
128 


I'arc.  Ainbroise,  extracts  from 
diary  of,  i,  480-4CS5 

I'.ury,  Sir  Ldward,  Kaisers- 
werth  plan  .ittcmpted  by, 
ii,  68-6y 

Paula  .as  a  nurse,  i.  141 

Pennsylvania  Hospital,  dif- 
ticulty  with  women  mana- 
gers, ii,  ?,:^-^~,i,i^\  estab- 
lishment of,  ii,  335-336; 
establishment  of  training 
school,  ii,  338 

Persians,  early  hospitals  ami 
charities  of.'  i,  45-46 

Pfahler,  J.  G.,  on  nurses, 
work,  i,  535 

Phebe,  the  first  deaconess, 
Work  of,  i,  to  1-102 


458 


Index 


Pilgrimages,     carlv,      i,     97, 

'7  "-'7.5. 
Plague  epidoiniis,  absence  of 

nursing  during,  i,  45^ 
Pre-Christian  ]'erio(l  of  nurs- 
ing, i,  i-<;2 
Pre-l"lie<lner    movements    of 

jihilanthrojiy  and  nursing, 

1,  S25-54') 
Pre-Xightingaic  times,  it,  62- 

100 
Pre[)aratory     instruction     of 

nurses  at  Kaiserswerth,  ii, 

,^0.  .^i,  40-41 
Primitive  man  and  the  care 

of  the  sick,  i,  12-25 
Prisoners,   refuge   for,  cst;il>- 

lished  at  Kaiserswerth.   ii, 

10 
Pusey.     Dr.     interest    of.   in 

nursmg  reform,  ii.  75,  76 


(^)uakers.  influence  of,  u])on 
reforms,  i.  5?  1 ;  work  of,  m 
Philadelphia,  ii,  74,  336, 
,^",'^.  .  t;  wurk  of  Eliza- 
beth 1  iv,  ii.  6,  i(),  70-76: 
work  of  William  Rathbone, 
ii,  2()4-2g5 

Quiet  in  the  sick-room, 
Florence  Nightingale  on, 
ii.  2  i() 


Radcgunde,  work  f)f.  i,  i5() 

kaliere,  founder  of  St.  Bar- 
tholomew's Hospital,  i,  452, 
455 

Rathbone,  Williatn.  work  of, 
li,  2()4~205 

Reading  aloud  in  the  sick- 
room, Florence  Nightingale 
on,  ii,  218 

Red  I'ross  Knights,  or  Temp- 
lars,   origin    and    puqjose, 


i,  187-1S8 


Red  Tross  Society,  origin  of, 

ii,    .si4-,ii6;    princijiles   of. 

''•    3'7~"3"'.    "ork    of,    11, 

320-525 
Red  ('ross  work,  earliest  ex- 

.-iniples  of,  ii,  5  12-3  15 
Reform  in  nursing,  inlluenie 

of    Xaiioleijnic    war    on.    1, 

540;   influence  of   .Ni^'htin- 

gale  School  on,  ii.  183- kS(). 

206;  molical  profession  in, 

ii.  360 :  opposition  to,  i,  537 
Reichardt,      (iertrude,      first 

Kaiserswerth  deaconess,  ii. 

It 
Religious   nursing,   expulsion 

of.  1.  460 
Remini.scence  of  one  of    tlie 

tirst    ])robationers    at    St. 

Bartholomew's      Ho.spital, 

ii.  304-31  1 
Rhenish-West phali.m    Prison 

Association,     founduig    of. 

ii,  6 
Richards,  Linda,  -.vorl    of,  ii, 

351,  4  1 11-423 
Roman    matrons    ancl    e.irly 

hosjiitals,  i,  i  iH-i  43 
Royalty,  nur--"- .^  by,  i,  J57- 

i5(;,34S-3,, 
Rules  go\erning  St.  \'incent 

de  Paul's  Sisters  of  Charity, 

i,  422-4.'5,  431 


St.  Bartholomew's  Hospital, 
early  tlays  of,  i,  457-460; 
municipal  control,  i,  40 1; 
ol'ticers,  i,  461;  origin,  i, 
452,  455;  physicians'  duties 
i,  465;  reminiscence  of  a 
jirobationcr,  ii,  304-311 

St.  Catherine,  work  of,  i,  229- 
232 

St.  Catherine's  General  and 
M.inne  Hospital,  one  of 
the    jiioneer    hospitaN,    11, 

354-335 
St.  l^phrem  and  e  irly  hospi- 
tal work,  i,  I  20 


Index 


459 


of.  ii, 


St.  Francis  of  Assisi.  work  (^f, 
i.  211-214 

St.  John  Chrysostom,  hos- 
pital at  ("onstantinople 
toundefi  hv,  i,  127 

St  John  the  Ahiioner.  Hospi- 
tal of.  ori^'in  of,  i,  174-175: 
rule  regarding  reception 
of  patients,  i,  184 

St.  John's  House,  London, 
connection  with  Charing 
Cross  nosi)ital.  ii,  g4;  con- 
nection with  King's  College 
Hospit.il,  ii,  ()o-(;i;  ditli- 
culties  with  King's  College, 
ii,  (>,:i-(;4;  f(nin(lir.g  of,  ii, 
So;  organisation  of,  ii,  82; 
and  the  Crimean  War,  ii, 
86  -S(, 

St.  Thomas's  Hospit.al,  duties 
of   matron,    i,    463;    duties 
of  nurses,  i,  464,  466-4O7; 
duties  of  the  Sister,  i.  406; 
-Nightingale       School       for 
nurses  established,  li,   i.Si; 
.-igm,  i,  462 
St.  Vincent  de  Paul,  chanac- 
ter  of,   i,   405;  division  of 
I)oor   by,    i,    410;   first   or- 
g.anised  charity  by,  i,  406; 
c]>posii,ijii  of,  to  monastic 
\ows  among  Sisters,  i,  422; 
rescue  and  relief  of  galley- 
sl.ives  by,   i,   411;  rules  to 
Sisters,  i,  422:  work  for  the 
Welfare  of  children,   i,   4^6 
St.  \'incent  de  Paul,  (Jrderof, 
at  Angers,  i,  426;  at  .Alans, 
i,    430;   at    Xantes,   i,    42<k 
first  vows  of  Sisters,  i,  430; 
growth  and  activity  of,   i, 
437;   introduction  of,   into 
United  St.ites,  i,  439;  pre- 
sent  aciivity    ii    Rome,    i, 
345;    rules   of,    i,    422-425, 

San  Hcrnardino,  work,  i,  244 
Sanit.iry    Commission,    crea- 
tion of,  at  the  opening  of 
the  Ci\  il  War,  ii,  360;  work 

of,  il,  T,(}2-i();^ 


Sanitation  in  Indi.i,  I'lorcnce 
.Xightingaleon.  ii,  232-2^7; 
of  early  hospitals,  "i,  249- 

Saracens,  hospit.ils  of,  i,  246 
Sarrazin,  naturalist  and  phy- 
sician, i,  31);: 
I    Savages,    nursing    .among,    i, 
[21-25 

J    Schuyler,    Louisa,    work    of, 
i     _  ii,  358--360,  37  I 
.Scurvy,    treatment     bv     In- 
dians, i,  i,()2 
Scutari    hosi>ital,    conditions 
during   the  Crimean   War. 
ii,  121-124,  138-141 
Secular  or<lers,  rise  of,  i,  257- 

2  So 
Servant-nurses      at      Hotcl- 
Dieu,  Lyons,  i.  2S3-284;  at 
Hotcl-Dieu,    Paris,  i,    328 
in  England,  i,  502-503' 
Sieveking,  Amalie.  establish- 
ment of    friendly    \-isiting 
by,  i,  546-548;  first  nursing 
Work  of,  i,  545 
Sisterhoods.        See    Nursing 

orders 
Sisterhoods,     Protestant,     in 
connection    with    nursing. 

Sisters  of  Charity  (src  also 
Xursing  orders)!  at  Angers, 
i,  42f>;  at  Mans,  i.  430;  at 
Xantes,  i,  421,;  first  stej) 
toward  founding  of,  i,  416; 
nursing  duties  "  restricted, 
i,  438;  opposition  to,  i, 
420;  original  homeof,  1,420 

South,  Dr.  J  F.,  ojjposition 
of,  to  the  .Nightingale 
school  for  nurses,  ii,  177- 
iSi 

Soyer,  Alexis,  de.scrijjtion  of 
I'lorcnce  Xightingale,  ii, 
128-1 2g 

Spanish  hospitals  in  America, 
i,  402   403 

Spiri*".il  care  of  patients, 
I-  !  'spondence  with  early 
1^   ,^lish  hospitals,  i,  509 


4f)0 


Index 


Steamer  c!iair  and  bed  com- 
bined, first  use  of,  i,  255 

Stecvens,  Madam,  founder  of 
oldes*  hospital  in  Dublin,  1, 
47a 


Teutonic  Knights,  origin  and 

])ur|iose.  i,   iS(i-n;o 
Theory    in    nurses'    training, 

I'loreneo    Nightingale    on, 

ii,  i74--275 

Thermometer,  use  of,  recom- 
nii'iided,  i,  2-; 2 

Tliiril  Onier  of  St.  Francis, 
origin  of,  i.  217-218 

Thouvenin,  Barlie,  head  of 
Sisters  of  St,  I'harles  dc 
Nancy,  i.  ,u.i 

Training  of  nurses  as  recom- 
mended by  Dr.  (iooch,  n, 
65-60;  iirst  writings  on,  by 
a  woin.in,  ii,  18;  Florence 
Nighlmgaleon,  ii  ,  52-257, 
2(,'4-2<)7,  27  1-280 

Training  of  women  for  useful 
lives  urged  by  Sir  Thomas 
More,  ii,  6^ 

Training  school  for  nurses, 
first  in  America,  li,  .^^g 

Training  schools,  Florence 
Nightingale  on  the  essen- 
tials of,  ii,  265-267;  mod- 
ern, coinpaa-d  with  Kai- 
serswerth,  ii,  40;  trio  of,  11, 

370-4.^5 
Treaty    of    (leneva    ami    the 

Red  Cross,  li.  3  12-^25 
Trio  of   training  schools,    ii. 

Tuke,  William,  work  of,  i,  450 
Twining,    L()Ui-ia,    establish- 
ment   of    Flower    Mission 
by,  ii,  2(jj;  work  of,  ii,  287- 
288,  290,  292-203 


U 


Unity  among  nurses,  Florence 
Nightingale  on,  ii,  277-27S 


Ventilation,  Florence  Night- 
ingale on,  ii,  21 1-2  I  2,  lack 
of,  in  early  hospitals,  i, 
^252-25,^  5,^8 

Virgins,  work  of,  i,  107-113 

Visiting  nursing  by  Mme.  do 
t'hantai,  i,  351;  by  saints, 
i,  219,  22H;  by  Sisterhood 
of  the  Common  Life,  1,  274; 
by  Sisters  of  St.  C^harles  de 
Nancy,  i.  344;  early  e.x- 
anijjles  of,  i,  102,  105;  first 
examjile  of,  i,  102 

Visiting  nursing  order  of  the 
V^isitation  of  .Mary,  organ- 
isation and  work,   1,   352- 

3. S3 
von  der  Recke  V'ollmcrstein, 
Count,  work  of,  in  nursing 
reform,  i,  542 

W 

Ward,  Mary,  pioneer  of  re- 
sistance to  enclosed  com- 
munities, i,  353. 

Wardroper,  Mrs.,  matron  of 
St.  Thomas's  Hospital, 
London,  ii.  188-195;  me- 
morial of,  by  Florence 
Nightmg.tle.  li,  i()o-i()4 

Warrington,  Dr  Joseph,  work 
of,  ii,  341-345 

Westchester  I'oorhouse,  in- 
vestigation    of,     ii,     373- 

Widows,  work  of,  i,  107-113 
Witches  and  sorcery  in  dis- 
ease, 1,  14,  16-21.  45 
Woman's  Kducational  As.so- 
ciation,  work  in  connec- 
tion with  Massachusetts 
General   Hosjutal,  ii,  413- 

414 

Woman's  IIoS{)ital  in  Phila- 
delphia, establishment  of 
training  school,  li,  ^46 

Woman's  Society  for  Nursing 
the  Sick,  i.  54'j 


Ill 


ik\ 


4()i 


1 


Women,  activity  of,  during,' 
Napoleonic  w.ir.  i,  540; 
as  i)hyMcians  and  sur- 
geons durinij  the  Middle 
Ai^es,  i,  <)7;  as  physicians 
and  surgeons  in  fiction,  i, 
347;  as  teachers  of  medi- 
cine, i,  162;  at  heau  of  early 
monastic  nursing,  i,  147- 
150;  inch.iritahleand  nurs- 
ing work  in  the  seventeenth 
century,  i,  407;  value  of, 
in  hospital  work  as  shown 
at  Kaiserswerth,  ii,  4.;: 
work  of,  during  the  Civil 
War,  ii,  v^'"^  •,>'>?:  workers 
of  the  early  church,  i,  i)\- 

"7  ' 

Women's  Central  Relief  Asso- 
ciation, organisation  and 
work  of,  11,  Jjo-jbi 


Work  among  fallen  women, 
i,  i()2 

Workhouse  iniirmaries,  intro- 
duction of  nursing  into, 
ii,  2()4 

Workhouse  reform  by  Agnes 
Jones,ii,2()7-2v,S:l.yI  luisa 
Twinmg,  ii,  2S7    2S8,  2(jo 

Wylie.  Dr.  Oill  account  of 
visit  to  St  Thomas's  Hos- 
pital, ii,  202-20 \;  assist- 
ance of,  in  nursing  reforni 
at  Bcllevue  Hospital,  ii. 
377 

X 

Xenodochium,  or  home  for 
strangers,  establishment  of, 
i,  IK).  I  2  ? :  Work  and  scope 

of    i,   I2I-1JJ 


n 


By  MICHAEL  /v^YERS  SHOEMAKER 


Islands  of  the  Southern  Seas 


Witli  So  11 


>tr,iti()ns.        Second 
Ciilt  top.     $2. 


-•dition. 


La 


r.U«-  8  . 


I  he  a  thorhas  not  only  aciiltnred  style  and  highly  desrriptivp  pimer 
!.ia  a  cuiiet,  delightful  humor.  Mun-over,  he  is  alw.iys  imereiiin^,  ,vcn' 
when  describing  the  d.uly  incidents  of  a  tour  thronfc;h  New  Zealand  n.d 
la^mania.      .  . 'Islands  of  the  .Sr.uthern  Seas  '   is  one  of  the  few  b...>ks 

•  ■(  mn   ern  travel  that  are  worthy  of  being  kept  and  read  over  and  over  again 


Ihe  illustrations  throughout  arc-  excelleru  and  as  fittingly  clear  and   „„  ,„.e 

A   more  readable  book   on  the  nowadays 


,  ,      ,  ,     T      -      ,-"  " —  Jgly  clear  a 

as  the  author  s  style  demands.      A   more  readable  book   on  the 
somewhat  hackneyed  subject  of  travel  in  the  Southern  .Seas  has  never  been 
printed,  and   we  unhesitatingly  commend  it  "—London  ClimnuU 


Quaint  Comers  of  Ancient 
Empires 

Southern    India,  liuniia  and  Manila.     With   47   illus- 


trations.     Lariie  iS  .     (iilt  to 


V  •>     -.r 


Mr  Shorm.akerwntesdescrip'ively  entertainingly,  with  ease,  one  would 
■0  ,  ll'C.imed  to  the  '.luaini  corners'  which  he  Msited  a  very  inquiring 
iiund,  as  well  as  l  phot.,graphic  eye,  and  sought  out  answers  tomany  queries 
as  10  the  why  ..f  things  he  saw,  so  that  his  observ.itions  and  recollections 
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Petersburg  iv)  F^ekin 

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S;mp|e,  direct,  and  graphir.      Kmph.asi/es  the  commercial  and  national  ti.s- 
Blbllltlcs  ol  Kussiasiiiduslri.il  development."— /,«/«-rjry  AVmo. 

"  The  only  authorii>  of  Its  kind  on  a  great  subject."— AiY^rary  M-W/J. 

Siiid for  descriptive    cirrular. 


G. 

M;W   YORK 


P.  PUTNAM'S  SONS 


I.ON[><)N 


By  M      .lAEL  HYlERS  SHOEHAKER 

Palaces  and  Prisons  of  flary 
Queen  of  Scots 

Revised  b_v  Thomas  A.li-n  Cro'>.'t-ii,  F.S.A.  (Scot.) 
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whose  tr.igic  ca'.-er  more  contrnvrrsv  has  rai;ed  than  comerninj;  any  other 
personage  in  the  hisror>-  of  these  islands.  .  .  .  Thi.se  who  are  fasci- 
nated by  the  gr.-it  romance,  wlio  have  as  yet  made  no  dc-tailed  study  of  the 
pen  ,d,  vill  I'lnd  tiie  st.  ryhere  outlined  hy  a  trustworthy  hand,  an''  adorned 
by  a  wealth  of  artistic  illns'ration  worthy  of  so  picturesque  and  royai  a 
theme."  — .S7.  James's  Gazette, 

The  Heart  of  the  Orient 

Sauntenn-s  through  (ieorgia,  Arineiiia,  Persia,  Turko- 
niania,  and  Turkestan,  to  the  Vale  of  Paradise.  8\ 
With  52  illustrations.      \et,  $2.50. 

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<'f  Kiroliiz.  They  include  also  ailesrripiion  ■•(  a  larantass  j'Uirney 
through  '  entr.il   Asia. 

".Mr-  Shoemaker's  descriptive  powers  are  of  the  tiest,  He  writes  enter- 
tainingly, he  is  lie.  IT  tiresome,  and  is  always  enjoyable;  his  observation  and 
statements  <f  fait  are  iinustially  .1  Lurate,  his  style  is  ple,isanl.  For  b'g 
and  for  little,  with  all  that  makes  up  the  intermediate,  "The  Heart  of  the 
Orient,'  with  its  ex.  i-llenl  illustrations  and  its  1  uilured  letterpress,  is  cme  of 
the  best  bo.  ks  of  trav.-l  tb.ii  we  have  re. id  in  .i  I.  rij^  time,"      I imes. 

Winged  Wheels  in  France 

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.Swit/irlami,  It  is  in  no  sense  of  the  word  a  pmdphook  ;  no  set 
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ains, visitslong-for^;otten  castles,  or  goes  in  quest  of  deserted  alibeys, 
Si-'iJ  for  Ji-'ii-ripfive  ri'-cdar. 


Q.  F>.  PUTNAM'S  SONS 

NEW   YORK  LONDON 


1 


